Hypoxemia

Hypoxemia is low levels of oxygen in your blood. It causes symptoms like headache, difficulty breathing, rapid heart rate and bluish skin. Many heart and lung conditions put you at risk for hypoxemia. It can also happen at high altitudes. Hypoxemia can be life-threatening. If you are experiencing symptoms of hypoxemia, call 911 or go to the ER.

What is hypoxemia?

Hypoxemia is when oxygen levels in the blood are lower than normal. If blood oxygen levels are too low, your body may not work properly. Someone with low blood oxygen is considered hypoxemic.

Oxygen gets to your blood through your lungs. When you breathe in, oxygen from the air travels through your lungs into small air sacks (alveoli). Blood vessels (capillaries) travel close to the alveoli and pick up the oxygen. Finally, oxygen travels through your blood to your tissues.

Hypoxemia can happen if you can’t breathe in enough oxygen or if the oxygen you breathe in can’t get to your blood. Air and blood flow are both important to having enough oxygen in your blood. This is why lung disease and heart disease both increase your risk of hypoxemia.

Depending on the severity and duration, hypoxemia can lead to mild symptoms or lead to death. Mild symptoms include headaches and shortness of breath. In severe cases, hypoxemia can interfere with heart and brain function. It can lead to a lack of oxygen in your body’s organs and tissues (hypoxia).

Hypoxemia can happen for a short duration leading to “acute” respiratory failure. In situations where it's a long-term problem over months and years, you may hear it referred to as “chronic respiratory failure”.

Hypoxemia vs. hypoxia: What’s the difference?

You may hear the words hypoxemia and hypoxia used interchangeably, but they aren’t the same. The names sound similar because they both involve low levels of oxygen, but in different parts of your body.

Hypoxemia is low oxygen levels in your blood and hypoxia is low oxygen levels in your_ _tissues. Hypoxemia can lead to hypoxia and they often both appear together, but not always. You can be hypoxemic but not hypoxic and vice-versa.

Who does hypoxemia affect?

Any condition that reduces the amount of oxygen in your blood or restricts blood flow can cause hypoxemia. People living with heart or lung diseases such as congestive heart failure, COPD or asthma, are at an increased risk for hypoxemia. Some contagious illnesses, like influenza, pneumonia and COVID-19, can also increase your risk of hypoxemia.

What are the symptoms of hypoxemia?

Hypoxemia symptoms vary depending on the severity and underlying cause. Some hypoxemia symptoms include:

1. Headache.
2. Difficulty breathing or shortness of breath (dyspnea).
3. Rapid heart rate (tachycardia).
4. Coughing.
5. Wheezing.
6. Confusion.
7. Bluish color in skin, fingernails and lips (cyanosis).

How is hypoxemia treated?

Depending on the underlying cause of hypoxemia, medications or other treatments can help raise your blood oxygen level. To help raise oxygen levels, your provider might use “supplemental oxygen” via oxygen tanks or oxygen concentrators. These may be needed continuously or only with exertion depending on the severity of the disease.

In the case of severe hypoxemia, especially with acute respiratory distress syndrome, healthcare providers may use a machine that breathes for you (ventilator). If hypoxemia doesn’t resolve, a condition known as refractory hypoxemia, additional medications or therapies may be used.

Treatments, which focus on the underlying cause, may include:

1. Inhalers with bronchodilators or steroids to help people with lung disease like COPD.
2. Medications that help to get rid of excess fluid in your lungs (diuretics).
3. Continuous positive airways pressure mask (CPAP) to treat sleep apnea.
4. Supplemental oxygen may be used to treat an ongoing risk of hypoxemia. Oxygen devices vary, but you can expect to get a machine that delivers extra oxygen through a breathing mask or small tube (cannula). You may receive oxygen at home, with a portable machine while you travel, or in the hospital.

How can I reduce my risk of hypoxemia?

The best way to reduce your risk of hypoxemia is to manage any underlying conditions that can lower your blood oxygen levels. If you're living with lung or heart conditions, talk to your healthcare provider about your concerns and specific ways to lower your risk.

Even for those without heart or lung conditions, certain medications and situations — like traveling to a higher altitude — can increase your risk of hypoxemia. Ask your provider about any special precautions you need to take while traveling or taking medication. Allow time to safely adjust to higher altitudes when you travel.

How can I raise my oxygen level?

Managing any underlying conditions is the best way to keep your blood oxygen at safe levels and lower your risk of hypoxemia.

1. Don't ignore new symptoms. Trust yourself if you feel something is off. Contact your healthcare provider or go to the ER.
2. If your healthcare provider prescribes oxygen, use it as directed.
3. Practice pulmonary hygiene. If you have COPD or asthma, know your triggers and make sure you always have a rescue inhaler with you if prescribed. Commit to using an incentive spirometer, performing breathing exercises and following any other recommendations for lung health from your healthcare provider.
4. Quit smoking. If you smoke, quitting can help increase lung function to bring more oxygen into your lungs. Quitting also helps prevent further damage to your lungs.
5. Take any medication as prescribed by your healthcare provider.
6. Make a plan for high altitude travel. Even those without heart or lung conditions can have trouble breathing at high altitudes. Understand how it might affect you and make a plan for how to adjust to the change. Know what you will do ahead of time if you should need medical attention. Give yourself plenty of time to adjust if necessary and make sure to bring any extra equipment or medication you might need.