沉默缺氧

无呼吸困难症状的缺氧

沉默缺氧(Silent hypoxia)又称隐形缺氧快乐缺氧(happy hypoxia)[1][2],是没有出现呼吸困难症状的缺氧[3][4][5][需要可靠医学来源],目前已知是2019冠状病毒病的并发症之一[6][7],目前推测此疾病是因为COVID-19病毒影响肺内气道的血流以及肺中的血管,但没有严重到会呼吸困难的程度[8]。目前也怀疑沉默缺氧是因为肺部形成小血栓所造成[9][10][11][需要可靠医学来源]。目前发现COVID-19患者的呼吸率会渐增,接著慢慢进入沉默缺氧[12][需要可靠医学来源];而且也已证实同样活动后,COVID-19患者和非COVID-19肺炎病患相比,有较轻的呼吸困难症状[13];这种情况也是非典型肺炎[14][需要可靠医学来源]高山症的症状[15]

沉默缺氧
类型缺氧
风险因素COVID-19高山症
分类和外部资源
医学专科重症医学感染科英语infectious disease (specialty)胸腔医学
[编辑此条目的维基数据]

诊断

“六分钟行走测试”(six-minute walk test,6MWT)可以用来诊断沉默缺氧[16],主要是用正常的步伐走六分钟,监控身体的反应[17]。目前已证实,COVID-19患者和特发性肺纤维化的非COVID-19患者比较,在六分钟行走测试后,比较会有运动引发的无症状缺氧[18]。此症状也可以在医院外用脉搏血氧浓度仪侦测[19][20]

预后

沉默缺氧可能会让血氧浓度低于50%,但不会被人注意到[21],因此其预后多半不好[22][23]

参考资料

  1. ^ Tobin, Martin J.; Laghi, Franco; Jubran, Amal. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. American Journal of Respiratory and Critical Care Medicine. 2020-08-01, 202 (3) [2022-07-28]. ISSN 1073-449X. PMC 7397783 . PMID 32539537. doi:10.1164/rccm.202006-2157CP. (原始内容存档于2022-10-20) (英语). 
  2. ^ LaMotte S. Silent hypoxia: Covid-19 patients who should be gasping for air but aren't. CNN. 7 May 2020 [2021-05-29]. (原始内容存档于2021-01-04). 
  3. ^ Pappas S. 'Silent hypoxia' may be killing COVID-19 patients. But there's hope.. Live Science. 23 April 2020 [2021-05-29]. (原始内容存档于2020-11-27). 
  4. ^ Three reasons why COVID-19 can cause silent hypoxia. ScienceDaily. 19 November 2020 [2021-05-29]. (原始内容存档于2020-12-29). 
  5. ^ Emily H. Silent hypoxia and its role in COVID-19 detection. News Medical. 3 June 2020 [2021-05-29]. (原始内容存档于2020-11-29). 
  6. ^ Chandra, Atanu; Chakraborty, Uddalak; Pal, Jyotirmoy; Karmakar, Parthasarathi. Silent hypoxia: a frequently overlooked clinical entity in patients with COVID-19. BMJ Case Reports. 2020-09, 13 (9). ISSN 1757-790X. PMC 7478026 . PMID 32900744. doi:10.1136/bcr-2020-237207 (英语). 
  7. ^ Levitan, Richard. Opinion | The Infection That’s Silently Killing Coronavirus Patients. The New York Times. 2020-04-20 [2022-07-28]. ISSN 0362-4331. (原始内容存档于2021-01-09) (美国英语). 
  8. ^ Silent Hypoxia Typically Not the First Symptom of COVID-19, Other Early Symptoms Should Be Monitored. American Lung Association. 15 May 2020 [2021-05-29]. (原始内容存档于2020-12-12). 
  9. ^ COVID-19 complications: Silent hypoxia emerges as new killer in Kerala. The New Indian Express. 7 June 2020 [2021-05-29]. (原始内容存档于2020-09-25). 
  10. ^ Study explains why Covid-19 can cause silent hypoxia. The Tribune. 30 November 2020 [2021-05-29]. (原始内容存档于2021-01-14). 
  11. ^ Srivastava A. Blood clots in the lung may be a major cause of COVID-19 deaths. The Hindu. 23 May 2020 [2021-05-29]. (原始内容存档于2020-12-12). 
  12. ^ Wei-Haas M. They don't struggle to breathe—but COVID-19 is starving them of oxygen. National Geographic. 8 May 2020 [2021-05-29]. (原始内容存档于2020-11-01). 
  13. ^ Fuglebjerg, Natascha Josephine Ulstrand; Jensen, Tomas Oestergaard; Hoyer, Nils; Ryrsø, Camilla Koch; Lindegaard, Birgitte; Harboe, Zitta Barrella. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. 2020-10, 99 [2022-07-28]. PMC 7836996 . PMID 32663601. doi:10.1016/j.ijid.2020.07.014. (原始内容存档于2022-07-04) (英语). 
  14. ^ Bowden O. What is 'silent hypoxia'? The coronavirus symptom patients don't know they have. Global News. 12 May 2020 [2021-05-29]. (原始内容存档于2021-01-07). 
  15. ^ Ottestad, William; Søvik, Signe. COVID-19 patients with respiratory failure: what can we learn from aviation medicine?. British Journal of Anaesthesia. 2020-09, 125 (3) [2022-07-28]. PMC 7165289 . PMID 32362340. doi:10.1016/j.bja.2020.04.012. (原始内容存档于2022-08-02) (英语). 
  16. ^ 留意「快樂缺氧」醫師教2方法 沒血氧機也能自我監測 | 生活 | 重點新聞 | 中央社 CNA. www.cna.com.tw. [2022-07-28]. (原始内容存档于2021-06-11) (中文(台湾)). 
  17. ^ Six-Minute Walk Test. American Lung Association. [2021-05-29]. (原始内容存档于2020-10-01). 
  18. ^ Fuglebjerg, Natascha Josephine Ulstrand; Jensen, Tomas Oestergaard; Hoyer, Nils; Ryrsø, Camilla Koch; Lindegaard, Birgitte; Harboe, Zitta Barrella. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. 2020-10-01, 99 [2022-07-28]. ISSN 1201-9712. PMC 7836996 . PMID 32663601. doi:10.1016/j.ijid.2020.07.014. (原始内容存档于2021-01-14) (英语). 
  19. ^ Luks, Andrew M.; Swenson, Erik R. Pulse Oximetry for Monitoring Patients with COVID-19 at Home. Potential Pitfalls and Practical Guidance. Annals of the American Thoracic Society. 2020-09, 17 (9) [2022-07-28]. ISSN 2329-6933. PMC 7462317 . PMID 32521167. doi:10.1513/AnnalsATS.202005-418FR. (原始内容存档于2022-10-17) (英语). 
  20. ^ Torjesen, Ingrid. Covid-19: Patients to use pulse oximetry at home to spot deterioration. BMJ. 2020-10-27. ISSN 1756-1833. doi:10.1136/bmj.m4151 (英语). 
  21. ^ Teo, Jason. Early Detection of Silent Hypoxia in Covid-19 Pneumonia Using Smartphone Pulse Oximetry. Journal of Medical Systems. 2020-08, 44 (8). ISSN 0148-5598. PMC 7305055 . PMID 32562006. doi:10.1007/s10916-020-01587-6 (英语). 
  22. ^ Brouqui, Philippe; Amrane, Sophie; Million, Matthieu; Cortaredona, Sébastien; Parola, Philippe; Lagier, Jean-Christophe; Raoult, Didier. Asymptomatic hypoxia in COVID-19 is associated with poor outcome. International Journal of Infectious Diseases. 2021-01-01, 102. ISSN 1201-9712. PMC 7604151 . PMID 33130200. doi:10.1016/j.ijid.2020.10.067 (英语). 
  23. ^ Lari, Ali; Alherz, Mohammad; Nouri, Abdullah; Botras, Lotfi; Taqi, Salah. Caution against precaution: A case report on silent hypoxia in COVID-19. Annals of Medicine and Surgery. 2020-12-01, 60 [2022-07-28]. ISSN 2049-0801. PMC 7640922 . PMID 33169089. doi:10.1016/j.amsu.2020.11.007. (原始内容存档于2022-07-28) (英语).