What Oxygen Level Is Too Low For A Baby – Oxygen saturation (sO2) refers to the percentage of oxygen in the blood. Among other things, it provides information about the functional capacity of the lungs and the efficiency of oxygen transport in the blood. Oxygen saturation can be determined outside the body using pulse oximetry or blood gas analysis.
Oxygen saturation indicates the percentage of hemoglobin (Hb) filled with oxygen molecules.1 Oxygen inhaled through the lungs is absorbed by hemoglobin and delivered to the tissues via the blood. There, charged oxygen molecules are released into the cells.
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Hemoglobin (Hb) is a protein composed of four subunits. The most important function of hemoglobin is to carry oxygen in the blood. It is mainly found in erythrocytes (erythrocytes). It is also present in small amounts in plasma, bound to free Hb haptoglobin.
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Oxygen is picked up from the air we breathe by hemoglobin in the veins of the lungs, transported through the body in the blood and delivered to the cells in the tissues. Oxygenated hemoglobin is called oxyhemoglobin. After removing all the O2 molecules, it is called deoxyhemoglobin. In the discharged form, it can absorb carbon dioxide and return it to the pulmonary veins. CO2 is released and re-released there.
Normal arterial oxygen saturation (SaO2) in healthy adults is 95-99%. When measured by venous blood gas analysis (SvO2), the normal value of oxygen saturation is approximately 73%.4
Blood oxygen saturation is not directly affected by age or gender. The partial pressure of oxygen depends on age. Therefore, partial pressure decreases with age. 6
A slight increase in blood oxygen can be achieved by rapid, deep inhalation and exhalation (hyperventilation). This simultaneously reduces carbon dioxide (CO2) emissions.7
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In addition, oxygen saturation may also increase during oxygen therapy. However, adding more O2 when the blood is oxygen-deficient can increase the risk of lung failure, heart attack, cardiac arrhythmias, and organ failure. Too much oxygen is toxic to the body and can cause inflammation, oxidative stress or vasoconstriction in the lungs, cardiovascular and nervous systems.
According to a meta-study8 (2018), supplemental oxygen has a negative effect of 94-96% of the baseline value. According to the results of the study, the patient’s risk of death increases with oxygen saturation
When oxygen saturation is too low, it is called hypoxemia or hypoxia. With hypoxemia, the amount of oxygen in the arterial blood decreases. 10 Hypoxia is a lack of oxygen throughout the body or in individual tissues. Symptoms may include anxiety and restlessness, shortness of breath (shortness of breath), tachycardia (fast heart rate) and high blood pressure.
There are many causes of low oxygen saturation: various lung diseases can cause insufficient oxygen to the alveoli of the lungs (ventilation disorder). Diffusion disorders are also possible, where gas exchange between alveoli and capillaries is disturbed. In addition, blood diseases such as anemia or hematopoiesis cause impaired oxygen transport. Cardiovascular diseases, such as heart failure, cause insufficient oxygen supply to organs due to occlusion of blood vessels. In addition to disease, environmental factors such as extreme altitude can cause low blood oxygen levels. Poisoning, eg. medications, drugs or carbon dioxide decrease oxygen saturation. 14
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A special form of hypoxemia has emerged, especially related to COVID-19: many patients do not show signs of dyspnea or rapid breathing, despite severe hypoxemia, with oxygen saturation levels below 70%. This form of hypoxemia is particularly dangerous because, even without symptoms, pulmonary decompensation develops quickly and thus becomes life-threatening for patients. [/Efn_note] 15
Measuring oxygen saturation provides information about lung function. By determining venous blood saturation, blood flow, oxygen uptake, and tissue metabolic activity can be assessed. Peripheral oxygen saturation is also used to calculate arterial oxygen saturation (CaO2).16
Blood oxygen saturation is also measured during surgery or for continuous monitoring of patients under anesthesia in the intensive care unit. Oxygen saturation of the mixed or central veins is particularly important for resuscitation, as it allows the conclusion of the cardiac source.17
In emergency medicine, measurement of blood oxygen saturation is used to obtain an impression of the patient’s oxygen content and respiratory gas balance.
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In addition, oxygen saturation is measured to monitor the progress of chronic lung diseases such as asthma or COPD.18
In the following cases, e.g. It is medically useful to measure oxygen saturation in the presence of certain symptoms or for various examinations.
The partial pressure of oxygen is the pressure exerted by oxygen gas in the blood and is measured in kilopascals (kPa) or millimeters of mercury (mmHg). The higher the partial pressure of oxygen (pO2) in the blood, the higher the oxygen saturation. This relationship is not linear, but is S-shaped and can be represented as an oxygen dissociation curve (see Figure 4). Thus, above a given pO2, oxygen saturation increases slightly.
Fig. 4: The oxygen binding curve describes the relationship between the O2 saturation of hemoglobin and the partial pressure of oxygen in the blood.
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Shifting to the left means that hemoglobin can bind more oxygen for the same partial pressure of oxygen. Oxygen is more easily absorbed from the alveoli, and the bond between hemoglobin and oxygen is stronger. However, this means that less oxygen reaches the tissues.
Example: a shift of the oxygen binding curve to the left is seen in hypothermia (hypothermia). 22 For example, if you stay in very cold conditions for a long time, your body temperature can drop, which leads to hypothermia. local parts of the body (usually the arms and legs). or even the whole body.23
With a proper shift, the bond between hemoglobin and oxygen is weakened. Oxygen is not readily absorbed, but can be released more easily into tissues.
Example: with increasing physical stress, a decrease in pH is observed due to an increase in protons (tissue acidity) in the blood. In addition, there is usually an increase in body temperature and an increase in the partial pressure of CO2 due to oxygen demand. These factors and an increase in the concentration of 2, 3-BPG cause a shift of the oxygen binding curve to the right and ensure an easier access of oxygen to the tissues. However, hemoglobin does not bind oxygen very strongly, so the rate of respiration must increase. This relationship between pH, CO2 partial pressure, and oxygen dissociation curve is called the Bohr effect.
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In addition to the predictable effects on oxygen saturation or partial pressure (pH, CO2 concentration, temperature, 2, 3-BPG concentration), there are other factors that cause changes in arterial blood oxygen saturation – usually a decrease. Some of them are detailed below.
In healthy people, these changes do not cause any problems compared to daytime breathing. Conversely, in patients with lung diseases such as pulmonary hypertension, they often lead to a lack of oxygen in the arterial blood.24
People with sleep apnea may also be deprived of oxygen at night because breathing often stops, sometimes for up to two minutes. In severe cases of sleep apnea, the blood oxygen saturation of affected individuals is sometimes around 70%.25
A newborn’s blood circulation changes immediately after birth. Oxygen saturation is approx. Increases by about 50% after birth. 60-65% to 90-96% within 10 minutes.26 27
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As altitude increases, the atmospheric pressure and partial pressure of O2 (PO2) in the surrounding air decrease, preventing oxygen from being absorbed by hemoglobin. As a result, the partial pressure of oxygen in the blood decreases, and oxygen saturation decreases. Peripheral chemoreceptors sense oxygen saturation in the body and hyperventilation begins. This slightly increases alveolar PO2 and activates the sympathetic nervous system. As a result, the heart rate compensates for the lower O2 content per heart rate. However, the so-called acute adaptation cannot prevent the limitation of maximal oxygen transport and thus maximal aerobic capacity (VO2max). Thus, an untrained person loses 1% of VO2max per 100m at 1500m, resulting in a loss of 10% at 2500m, 25% at 4000m and 65% at 8000m.
During acute adaptation to altitude, systemic blood pressure does not change significantly because sympathetic activation and the direct vasodilator effect of hypoxia neutralize the peripheral circulation.
Altitude endurance training can be used specifically to improve performance. Low blood oxygen saturation at high altitude leads to various adaptation reactions in the long term:
Thus, training at altitude increases aerobic activity. Gas exchange soon becomes more efficient because oxygen can be better absorbed and transported further. However, acclimatization to this altitude takes time (approx