Asphyxia

Asphyxia - a state of breathlessness, accompanied by a critical drop in the oxygen level (hypoxia) and an excess of carbon dioxide (hypercapnia) in the blood and tissues. When asphyxia acute or subacute growing phenomenon of respiratory failure: the skin cyanosis, tachypnea, participation in the breath auxiliary muscles; terminally develops coma, convulsions, respiratory arrest and cardiac activity albuterol generic name. Status asphyxia is diagnosed on the basis of assessment of complaints and physical findings, pulse oximetry. In this case, it required emergency care, which includes the restoration of airway patency, oxygen inhalation, tracheotomy, ventilator, medical therapy.

Asphyxia - life-threatening condition associated with impaired gas exchange, and the development of hypoxic hypercapnic syndrome and leads to respiratory and circulatory disorder. In asphyxia be based on a dysfunction of the respiratory center, mechanical obstruction to the air entering the lungs, loss of respiratory muscles. All types and forms of asphyxia, regardless of the reasons, require the immediate (and sometimes intensive care) activities, as a few minutes after the onset of acute oxygen starvation, death can occur. In medicine, the problem is relevant to neonatal asphyxia, pulmonology, traumatology, toxicology, resuscitation and other disciplines.

All the reasons that lead to asfiksicheskomu state can be divided into pulmonary and extrapulmonary. The first of these is most commonly associated with external compression of the airways or intraluminal obstruction (obturation). Compression of the airways externally observed in strangulation (hanging, strangulation noose or hands), compression of the trachea, neck injuries, and so on. N. Obstructive disorder breathing is most often caused by the tongue, blockage of the trachea and bronchial foreign bodies, intraluminal tumors, inhalation of food , vomit, water drowning, blood in pulmonary hemorrhage. Acute respiratory tract stenosis may develop at traheobronhite, asthma attacks, allergic edema of the larynx, or burns, swelling of the vocal cords. Also among the causes of pulmonary gas exchange abnormalities include asphyxia, caused by acute pneumonia, massive exudative pleurisy, total pneumothorax or hemothorax, atelectasis, or pulmonary edema, pulmonary embolism

Among the extrapulmonary factors of asphyxia are leading the state, leading to the defeat of the respiratory center: intoxication, traumatic brain injury, stroke, an overdose of drugs and narcotics (such as morphine, barbiturates). Paralysis of the respiratory muscles, as the cause of asphyxia may develop on the background of infectious disease (botulism, diphtheria, polio, tetanus), spinal cord injury, poisoning kurarepodobnymi drugs, myasthenia gravis, and so on. Oxygen transport Abnormalities in the tissue occurs when massive bleeding, circulatory disorders, carbon monoxide poisoning, metgemoglobinoobrazovatelyami.

At the heart of traumatic asphyxia is damage or compression of the chest, obstructing breathing excursions. Asphyxia due to lack of oxygen in the inspired air, can occur during prolonged exposure in poorly ventilated mines and wells, with altitude sickness, in violation of a limited supply of oxygen in closed systems (eg divers). For newborn asphyxia often leads fetoplacental insufficiency, intracranial birth trauma, aspiration of amniotic fluid.

The mechanism of asphyxia in all types of suffocation has common pathogenetic features. The result is the accumulation of oxygen deficiency in the blood of the partial oxidation products with the development of metabolic acidosis. The cells develop severe violations of biochemical processes dramatically reduces the number of ATF, changes the course of redox processes, reduced pH, etc. The result is a proteolytic autolysis processes of cellular components and cell death...

First of all develop irreversible changes in the brain cells, and in case of damage the respiratory and vasomotor centers, death occurs quickly. In the heart muscle during asphyxia occur edema, degeneration and necrosis of muscle fibers. From the lungs marked alveolar edema and emphysema. The serous membranes (pericardium, pleura) found melkopyatnistye hemorrhage.

The clinical course of asphyxia is divided into four phases. The first phase is characterized by a compensatory increase in the activity of the respiratory center in the conditions of lack of oxygen. During this period, the patient arises fear, anxiety, agitation; dizziness, cyanosis of the skin, shortness of breath with forced inspiratory breath; tachycardia, increased blood pressure. When asphyxia caused by compression or airway obstruction, the patient is coughing badly, speaks hoarsely, attempts to release from squeezing factor; the face becomes puffy, purple-blue.

In the second phase on the background of exhaustion of compensatory reactions shortness of breath expiratory character becomes (amplified and lengthened exhalation) increases bluish color of the skin, slows respiratory rate and heart rate, decreased blood pressure. In the third, Preterminal phase, there is a brief cessation of the activity of the respiratory center: there are episodes of apnea, there is a drop in blood pressure, fading reflexes developed unconsciousness and coma. In the fourth and last phase of asphyxia occurs agonal breathing, marked convulsions, heart rate and blood pressure are not determined; possible involuntary urination, defecation and ejaculation. In pregnant women it can happen spontaneous miscarriage.

Asphyxia is usually complicated by ventricular fibrillation, pulmonary edema and brain, traumatic shock, anuria. The cause of patient death is usually a paralysis of the respiratory center. Acute development, death occurs within 3-7 minutes. In the long-term patients, survivors asphyxia, aspiration pneumonia may experience, vocal cord paresis, various types of amnesia, emotional status changes (irritability, apathy), intellectual disability up to the dementia.

In gradually developing asphyxia (for a few hours or days) the victim is sitting, torso and neck stretched forward; wide-open mouth eagerly catches air, tongue often protruding outward. The skin is usually pale, expressed akrotsianoz lips and nails; on the face of the fear of death is displayed. When asphyxia becomes decompensation phasic flow described above.