Question

Mechanism of hypoxemia during anesthesia

Answer 1

Hypoxia associated with anesthesia and surgery has an etiology which ranges from simple though rare accidents, such as airway obstruction, to the complicated but common disturbances in the intrapulmonary relation of ventilation to perfusion. Anesthetic agents, properly used, do not give rise to hypoxia; rather, the impaired oxygenation is caused by such factors as pre‐existing disease or trauma, the position of the patient, other mechanical interferences with ventilation, a less than optimal pattern of ventilation, and an inadequate oxygen carrying capacity. The response to hypoxia in anesthesia differs from that encountered in the healthy and conscious individual primarily by being tremendously variable. Not only is the response to hypoxia modified by age and disease, but anesthetic agents and a variety of other drugs so interfere with circulatory and ventilatory compensation in hypoxia that no well‐defined pattern can be described. The symptoms of hypoxia in anesthesia vary from the “normal” response, consisting primarily in tachycardia and mild hypertension, to the response seen in patients who are unable to provide a compensatory increase in cardiac output and ventilation. Under such circumstances hypoxia will lead to
bradycardia and hypotension.

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