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Asphyxia

Asphyxia is a condition of insufficient oxygen and accumulating carbon dioxide in the blood and tissues. It results from an interference with respiration. Asphyxia leads to cardiopulmonary arrest and is fatal without prompt treatment.

Causes

Asphyxia results from any internal or external condition or substance that inhibits respiration. Some examples include:

  • hypoventilation, stemming from narcotic abuse, medullary disease or hemorrhage, respiratory muscle paralysis, or cardiopulmonary arrest
  • intrapulmonary obstruction, associated with airway obstruction, pulmonary edema, pneumonia, and near drowning
  • extrapulmonary obstruction, as in tracheal compression from a tumor, pneumothorax, strangulation, trauma, or suffocation
  • inhalation of toxic agents, resulting from carbon monoxide poisoning, smoke inhalation, and excessive oxygen inhalation.

Symptoms

In most cases, the person fights and gasps for breath, has a rapid pulse rate, throbbing in the head as blood pressure rises and blueness of the skin. Eventually, there may be convulsions, followed by a state of paralysis, unconsciousness and death. However, in some instances, where the inhalation of toxic fumes such as carbon monoxide is responsible for the asphyxia, death may occur peacefully, without the struggles described above and during sleep. A person suffering from asphyxia requires urgent, prompt treatment if death is to be avoided.

Diagnostic tests

Arterial blood gas (ABG) analysis, the most important test, indicates decreased partial pressure of arterial oxygen (less than 60 mm Hg) and increased partial pressure of arterial carbon dioxide (more than 50 mm Hg). Chest X-rays may detect a foreign body, pulmonary edema, or atelectasis. Toxicology tests may show drugs, Chemicals, or abnormal hemoglobin. Pulmonary function tests may indicate respiratory muscle weakness.

Treatment

Asphyxia requires immediate respiratory support with cardiopulmonary resuscitation (CPR), endotracheal intubation, supplemental oxygen, mechanical ventilation, and pulse oximetry, as needed. It also calls for prompt treatment of the underlying cause: bronchoscopy for extraction of a foreign body; a narcotic antagonist, such as naloxone, for narcotic overdose; and gastric lavage for poisoning.

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