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Asphyxia: Causes, Symptoms & Treatment

Asphyxia is a life-threatening condition caused by a lack of oxygen and a rise in carbon dioxide in the blood, which can lead to unconsciousness and death without prompt treatment.

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Things worth knowing about "Asphyxia"

Asphyxia is a life-threatening condition caused by a lack of oxygen and a rise in carbon dioxide in the blood, which can lead to unconsciousness and death without prompt treatment.

What is Asphyxia?

Asphyxia is a medical emergency in which the body is deprived of adequate oxygen while carbon dioxide levels in the blood rise dangerously. This condition results from a disruption in breathing and can cause permanent brain damage or death within minutes. Newborns, elderly individuals, and people with certain pre-existing conditions are at particular risk.

Causes

Asphyxia can be triggered by a wide range of factors. These are generally divided into external and internal causes:

External causes: Choking on a foreign object, drowning, strangulation, compression of the airway, or inhalation of smoke or toxic gases.
Internal causes: Severe asthma attack, anaphylactic shock, laryngeal edema (swelling of the larynx), pulmonary embolism, pneumothorax (collapsed lung), or neurological conditions that paralyze the breathing muscles.
Perinatal asphyxia: A special form known as birth asphyxia occurs when a newborn receives insufficient oxygen during or shortly after delivery.

Symptoms

Symptoms of asphyxia develop rapidly and worsen quickly:

Shortness of breath and respiratory distress
Bluish discoloration of the lips, fingers, and skin (cyanosis)
Confusion, disorientation, and feelings of panic
Loss of consciousness
Cardiac arrest in the final stage

In newborns, asphyxia is indicated by absent or weak breathing after birth, a low Apgar score, limpness, and pale or bluish skin color.

Diagnosis

Diagnosis of asphyxia is primarily clinical and based on the visible signs of respiratory distress and oxygen deprivation. Additional diagnostic measures include:

Pulse oximetry: Non-invasive measurement of blood oxygen saturation using a sensor.
Blood gas analysis: Measurement of oxygen and carbon dioxide levels as well as blood pH.
Imaging: Chest X-ray or CT scan to identify structural causes such as a collapsed lung or foreign body.
Endoscopy: Used when a foreign object in the airway is suspected.

Treatment

Treatment of asphyxia is a medical emergency and must begin immediately:

Airway management: Removal of foreign bodies, patient positioning, intubation or tracheotomy if necessary.
Oxygen administration: High-flow oxygen via mask or ventilator.
Cardiopulmonary resuscitation (CPR): Immediate chest compressions and rescue breathing in the event of cardiac arrest.
Treatment of the underlying cause: For example, epinephrine for anaphylactic shock, bronchodilators for asthma attacks, or surgical intervention for structural problems.
Therapeutic hypothermia in newborns: In cases of birth asphyxia, controlled body cooling is used in specialized centers to minimize brain damage.

Complications and Prognosis

The longer asphyxia persists, the more severe the potential consequences. Irreversible brain damage can occur after as little as 4 to 6 minutes without sufficient oxygen. Long-term effects may include cognitive impairments, motor disorders, epileptic seizures, or hypoxic-ischemic encephalopathy. The prognosis depends largely on how quickly the oxygen supply can be restored.

References

World Health Organization (WHO): Oxygen therapy for children. Geneva: WHO Press, 2016.
Pschyrembel Clinical Dictionary. 268th edition. Berlin: De Gruyter, 2020.
Gluckman PD et al. - Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. The Lancet, 2005; 365(9460):663–670.

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