Severe respiratory failure / Severe hypoxemia

Critical urgency
-Very severe

It is the partial pressure drop of blood oxygen below 80% (normal values are above 95% approximately). This translates to a low level of oxygen in the blood.

It may be due to respiratory failure due to respiratory pathology (COPD, asthma, cystic fibrosis, pulmonary edema...), inspiratory difficulty, obstruction or damage to the lungs or respiratory tract (e.g. foreign body in the larynx), altitude sickness (in high regions where the inhaled air has less oxygen), acute cardiac pathology or problems in the gas exchange in the alveoli.

Symptoms include: breathing difficulty, shortness of breath, rapid breathing, headache, bluish color (starting on the lips and/or nails), increased heart rate, coughing, noises when breathing.

To reach a diagnosis, your vital signs (heart and respiratory rate, blood pressure, oxygen saturation) will be taken, you will be asked about your medical history, as well as requesting blood gas analysis and/or blood tests and a chest X-ray.

The treatment will depend on the severity and is based on applying oxygen therapy (invasive or not, as required), respiratory physiotherapy, bronchodilator drugs, corticosteroids, vasoactive drugs, depending on the particular case.

If you have any of these symptoms and feel short of breath, go to the nearest emergency department.

Bibliographic references
  1. R. Rodríguez. Insuficiencia respiratoria. Farreras Rozman. Medicina Interna. Volumen I. Duodécima edición. 707:719.
  2. J. F. McConville, B. Mokhlesi, J. Solway. Trastornos de la ventilación. Harrison. Principios de Medicina Interna. Volumen II. Decimonovena edición. 1720:1723.
  3. UpToDate [Internet]. Waltham. 2017. Oxygenation and mechanisms of hypoxemia; [citado el 20 de julio de 2017]. Disponible en: http://www.uptodate.com/contents/oxygenation-and-mechanisms-of-hypoxemia?source=search_result&search=hipoxemia&selectedTitle=1~150
  4. UpToDate [Internet]. Waltham. 2017. Arterial blood gases; [citado el 20 de julio de 2017]. Disponible en: http://www.uptodate.com/contents/arterial-blood-gases?source=search_result&search=hipoxemia&selectedTitle=2~150
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Symptoms

    Pulse oximeter saturation below 80%


    Short of breath


    Shortness of breath at rest


    Sudden shortness of breath


    Oxygen saturation below 94%

Pre-hospital care recommendations

Call medical assistance for instructions.