沈默缺氧

无呼吸困难症状的缺氧

沈默缺氧(Silent hypoxia)又稱隱形缺氧快樂缺氧(happy hypoxia)[1][2],是沒有出現呼吸困难症狀的缺氧[3][4][5][需要可靠醫學來源],目前已知是2019冠状病毒病的併發症之一[6][7],目前推測此疾病是因為COVID-19病毒影響肺內氣道的血流以及肺中的血管,但沒有嚴重到會呼吸困难的程度[8]。目前也懷疑沈默缺氧是因為肺部形成小血栓所造成[9][10][11][需要可靠醫學來源]。目前發現COVID-19患者的呼吸率會漸增,接著慢慢進入沈默缺氧[12][需要可靠醫學來源];而且也已證實同樣活動後,COVID-19患者和非COVID-19肺炎病患相比,有較輕的呼吸困难症狀[13];這種情況也是非典型肺炎[14][需要可靠醫學來源]高山症的症狀[15]

沈默缺氧
类型缺氧
风险因子COVID-19高山症
分类和外部资源
醫學專科重症醫學感染科英语infectious disease (specialty)胸腔醫學

診斷编辑

「六分鐘行走測試」(six-minute walk test,6MWT)可以用來診斷沈默缺氧[16],主要是用正常的步伐走六分鐘,監控身體的反應[17]。目前已證實,COVID-19患者和特发性肺纤维化的非COVID-19患者比較,在六分鐘行走測試後,比較會有運動引發的無症狀缺氧[18]。此症狀也可以在醫院外用脈搏血氧濃度儀偵測[19][20]

預後编辑

沈默缺氧可能會讓血氧濃度低於50%,但不會被人注意到[21],因此其預後多半不好[22][23]

參考資料编辑

  1. ^ Tobin MJ, Laghi F, Jubran A. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. American Journal of Respiratory and Critical Care Medicine. August 2020, 202 (3): 356–360. PMC 7397783 . PMID 32539537. doi:10.1164/rccm.202006-2157CP. 
  2. ^ LaMotte S. Silent hypoxia: Covid-19 patients who should be gasping for air but aren't. CNN. 7 May 2020. 
  3. ^ Pappas S. 'Silent hypoxia' may be killing COVID-19 patients. But there's hope.. Live Science. 23 April 2020. 
  4. ^ Three reasons why COVID-19 can cause silent hypoxia. ScienceDaily. 19 November 2020. 
  5. ^ Emily H. Silent hypoxia and its role in COVID-19 detection. News Medical. 3 June 2020. 
  6. ^ Chandra A, Chakraborty U, Pal J, Karmakar P. Silent hypoxia: a frequently overlooked clinical entity in patients with COVID-19. BMJ Case Reports. September 2020, 13 (9): e237207. PMC 7478026 . PMID 32900744. doi:10.1136/bcr-2020-237207. 
  7. ^ Levitan R. The Infection That's Silently Killing Coronavirus Patients. The New York Times. 20 April 2020. 
  8. ^ Silent Hypoxia Typically Not the First Symptom of COVID-19, Other Early Symptoms Should Be Monitored. American Lung Association. 15 May 2020. 
  9. ^ COVID-19 complications: Silent hypoxia emerges as new killer in Kerala. The New Indian Express. 7 June 2020. 
  10. ^ Study explains why Covid-19 can cause silent hypoxia. The Tribune. 30 November 2020. 
  11. ^ Srivastava A. Blood clots in the lung may be a major cause of COVID-19 deaths. The Hindu. 23 May 2020. 
  12. ^ Wei-Haas M. They don't struggle to breathe—but COVID-19 is starving them of oxygen. National Geographic. 8 May 2020. 
  13. ^ Fuglebjerg NJ, Jensen TO, Hoyer N, Ryrsø CK, Lindegaard B, Harboe ZB. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. October 2020, 99: 100–101. PMC 7836996 . PMID 32663601. doi:10.1016/j.ijid.2020.07.014. 
  14. ^ Bowden O. What is 'silent hypoxia'? The coronavirus symptom patients don't know they have. Global News. 12 May 2020. 
  15. ^ Ottestad W. COVID-19 patients with respiratory failure: what can we learn from aviation medicine?. British Journal of Anaesthesia. 
  16. ^ 留意「快樂缺氧」醫師教2方法 沒血氧機也能自我監測 ,中央社,2021年5月26日
  17. ^ Six-Minute Walk Test. American Lung Association. 
  18. ^ Fuglebjerg NJ, Jensen TO, Hoyer N, Ryrsø CK, Lindegaard B, Harboe ZB. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. October 2020, 99: 100–101. PMID 32663601. S2CID 220530080. doi:10.1016/j.ijid.2020.07.014 . 
  19. ^ Luks AM, Swenson ER. Pulse Oximetry for Monitoring Patients with COVID-19 at Home. Potential Pitfalls and Practical Guidance. Annals of the American Thoracic Society. September 2020, 17 (9): 1040–1046. PMC 7462317 . PMID 32521167. doi:10.1513/AnnalsATS.202005-418FR. 
  20. ^ Torjesen I. Covid-19: Patients to use pulse oximetry at home to spot deterioration. The BMJ. 27 October 2020: m4151. S2CID 225078120. doi:10.1136/bmj.m4151 . 
  21. ^ Teo J. Early Detection of Silent Hypoxia in Covid-19 Pneumonia Using Smartphone Pulse Oximetry. Journal of Medical Systems. June 2020, 44 (8): 134. PMC 7305055 . PMID 32562006. doi:10.1007/s10916-020-01587-6. 
  22. ^ Brouqui P, Amrane S, Million M, Cortaredona S, Parola P, Lagier JC, Raoult D. Asymptomatic hypoxia in COVID-19 is associated with poor outcome. International Journal of Infectious Diseases. January 2021, 102: 233–238. PMID 33130200. doi:10.1016/j.ijid.2020.10.067 . 
  23. ^ Lari A, Alherz M, Nouri A, Botras L, Taqi S. Caution against precaution: A case report on silent hypoxia in COVID-19. Annals of Medicine and Surgery. December 2020, 60: 301–303. PMID 33169089. doi:10.1016/j.amsu.2020.11.007 .