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Don't (Ed Sheeran song)
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"Don't"
Single by Ed Sheeran
from the album ×
Released
24 August 2014 (2014-08-24)
Format
CD
digital download
Recorded
2013–14
Genre
R&B
Length
3:39
Label
Asylum
Atlantic
Songwriter(s)
Ed Sheeran
Benjamin Levin
Producer(s)
Rick Rubin
Benny Blanco
Ed Sheeran singles chronology
"Sing"
(2014) "Don't"
(2014) "Thinking Out Loud"
(2014)
"Sing"
(2014) "Don't"
(2014) "Thinking Out Loud"
(2014)
"Don't" is a song recorded by English singer-songwriter, Ed Sheeran, for his second studio album, × (2014). Written by Sheeran and Benny Blanco and produced by Blanco and Rick Rubin, the song samples "Don't Mess with My Man" by Lucy Pearl.[1] It was initially planned as the album's lead single, but was passed over in favour of "Sing". It was instead released to iTunes on 13 June 2014 as the second "instant grat" promotional single from ×. "Don't" officially impacted US contemporary hit radio on 15 July 2014 and was released independently on 24 August 2014 as the album's second single.
"Don't" peaked at No. 8 on the UK Singles Chart. In the US, it became Sheeran's first top 10 single. It also made the top 10 in eight other countries.
Contents
[hide]
1 Background and composition
2 Release and reception
3 Commercial performance
4 Music video
5 Live performances
6 Formats and track listings
7 Charts
7.1 Weekly charts
7.2 Year-end charts
8 Certifications and sales
9 Release history
10 References
11 External links
Background and composition[edit]
The song developed from a riff, which Sheeran had on his phone for a year.[2] Sheeran first recorded the track with producer Benny Blanco,[3] who was also credited as co-writer under his real name, Benjamin Levin. Sheeran recorded it again with Rick Rubin. The two producers coming together to produce the final cut. "Don't" is an R&B song[4][5] with a "blue-eyed soul hymn".[6]
The lyrics consist of three verses, which Sheeran elaborated: "The first verse is the setup, the second explains the situation, and the third is the outcome, with a chorus in between each."[7] A lyrical screed, it alludes to events attendant to the short-lived relationship Sheeran had with another singer.[8] He sings: "For me and her, we make money the same way/ Four cities, two planes in the same day."[9] Sheeran scorned the former girl for having sex with another guy, and expressed an expletive such as in the line "Don't fuck with my love".[6] Sheeran revealed he wrote the song out of frustration, and, story-wise, the lyrics are self-explanatory. He recalled the events that inspired his writing: "[...] it was one of those situations where someone comes across as a very, very sweet, innocent person, and you take that for granted, then stuff unravels and you see a different side to them."[2] The song was therapeutic because writing it made him feel better afterwards.[9]
Tabloids linked singer, Ellie Goulding (pictured), to Sheeran
About his other songs, Sheeran has openly stated who inspired the lyrical content.[10] But since the release of "Don't", he had remained silent to whom the song is directed to.[11] In a 2014 interview with Rolling Stone, Sheeran articulated that he had dated a few singers, but friend, Taylor Swift, was not among them, and in fact, he played the track to her. Tabloids linked the singers, Selena Gomez and Ellie Goulding, to Sheeran.[8] On 31 October 2015, Fuse posted an interview in which Sheeran says, "'Don't' is just a song that’s close to the bone and definitely opened up a door that I probably shouldn't have opened up. [...] I just won't say who it's about because... I mean everyone, everyone fucking knows anyway. But like I just won't say who it's about cause it's quite a negative song."[10]
In 2015, Ellie Goulding released "On My Mind" for her third studio album, Delirium. The song was described by many critics as an answer song to "Don't", an allegation Goulding had denied.[12][13][14][15][16][17]
"Don't" is written in the key of F minor with a tempo of 92 beats per minute.[18]
Release and reception[edit]
Sheeran did not intend to release the song on the album, because the lyrics were therapeutic and personal.[9][11] He was however persuaded by those who had heard the song to release it, as it was "an alright song".[9] He revealed that "the more [he] listened back [he] thought this is an alright song".[11]
"Don't" was planned to be released as the first single from the album until March 2014, when "Sing" was chosen.[19] Billboard speculated that the provocative, "Don't fuck with my love", chorus prompted the change.[3] Sheeran debuted a snippet of the song in a commercial for Beats by Dr. Dre in May 2014.[19]
On 13 June 2014, "Don't" was made available to customers, who pre-ordered ×, as the second "instant grat" promotional single,[20] following "One", and an official audio stream was released on Sheeran's YouTube page.[5] An extended play accompanied the release of the single, featuring a remix by Rick Ross, a live cover of Nina Simone's "Be My Husband", and a non-album song, "Everything You Are". Notably, Sheeran's lyrics aren't censored on the Rick Ross remix, but are on the album version. "Don't" officially impacted US contemporary hit radio on 15 July 2014.[21]
Jason Lipshutz of Billboard wrote: "[...] 'Don't' shows that Sheeran is not afraid to be dangerous, or even explicit, on his sophomore set."[6]
Commercial performance[edit]
In the UK, the song reached No. 8 on the UK Singles Chart on its ninth week on the chart.[22] As of September 2017, the song has sold 399,000 copies in actual sales, and it also has 67 million streams, giving a total of 1,073,000 combined units in the UK.[23]
In the US, "Don't" reached No. 9 on the all-encompassing Billboard Hot 100 chart; it marked Sheeran's first single to reach the top 10 on that chart.[24] The single has, as of January 2015, sold 1,464,000 digital copies in the US.[25]
Music video[edit]
An accompanying music video was released on YouTube on 4 August 2014. The video was directed by Emil Nava and follows a dancer (Phillip Chbeeb from I.aM.mE) going from poverty to wealth.[26] Sheeran makes a brief drive-by cameo appearance. 4Music called it a "compelling watch".[27]
Live performances[edit]
On 12 April 2014, Sheeran performed "Don't" on Saturday Night Live.[28] On 17 September 2014, Sheeran sang it during the season 9 finale of America's Got Talent.[29] On 6 February 2015, Sheeran performed the song on The Late Late Show; he was accompanied by John Mayer on the guitar.[30]
Formats and track listings[edit]
Digital download
No.
Title
Length
1. "Don't" 3:39
CD single
No.
Title
Length
1. "Don't" 3:39
2. "Friends" 3:10
Digital download – extended play
No.
Title
Length
1. "Don't" (Rick Ross Remix) 4:17
2. "Be My Husband" (Live from Glastonbury) 7:50
3. "Everything You Are" 3:58
4. "Friends" 3:10
Digital download – UK extended play
No.
Title
Length
1. "Don't" (Rick Ross Remix) 4:17
2. "Be My Husband" (Live from Glastonbury) 7:50
3. "Everything You Are" 3:58
Charts[edit]
Weekly charts[edit]
Chart (2014–15)
Peak
position
Australia (ARIA)[31]
4
Austria (Ö3 Austria Top 40)[32]
30
Belgium (Ultratop 50 Flanders)[33]
43
Belgium (Ultratop 50 Wallonia)[34]
48
Canada (Canadian Hot 100)[35]
7
Canada AC (Billboard)[36]
24
Canada CHR/Top 40 (Billboard)[37]
3
Canada Hot AC (Billboard)[38]
2
Czech Republic (Rádio Top 100)[39]
13
Czech Republic (Singles Digitál Top 100)[40]
10
Denmark (Tracklisten)[41]
8
Euro Digital Songs (Billboard)[42]
7
Finland (Suomen virallinen lista)[43]
17
France (SNEP)[44]
41
Germany (Official German Charts)[45]
17
Hungary (Stream Top 40)[46]
29
Ireland (IRMA)[47]
11
Israel (Media Forest)[48]
2
Lebanon (Lebanese Top 20)[49]
14
Netherlands (Dutch Top 40)[50]
15
Netherlands (Single Top 100)[51]
20
New Zealand (Recorded Music NZ)[52]
6
Poland (Polish Airplay Top 100) [53]
15
Scotland (Official Charts Company)[54]
10
Slovakia (Rádio Top 100)[55]
31
Slovakia (Singles Digitál Top 100)[56]
13
Slovenia (SloTop50)[57]
47
Spain (PROMUSICAE)[58]
43
Sweden (Sverigetopplistan)[59]
22
Switzerland (Schweizer Hitparade)[60]
7
UK Singles (Official Charts Company)[61]
8
US Billboard Hot 100[62]
9
US Adult Contemporary (Billboard)[63]
24
US Adult Top 40 (Billboard)[64]
3
US Country Airplay (Billboard)[65]
59
US Dance/Mix Show Airplay (Billboard)[66]
4
US Mainstream Top 40 (Billboard)[67]
2
US Rhythmic (Billboard)[68]
24
Year-end charts[edit]
Chart (2014)
Position
Australia (ARIA)[69]
42
Canada (Canadian Hot 100)[70]
56
Germany (Official German Charts)[71]
50
Hungary (Stream Top 40)[72]
99
Italy (FIMI)[73]
66
Netherlands (Dutch Top 40)[74]
65
Netherlands (Single Top 100)[75]
43
New Zealand (Recorded Music NZ)[76]
33
Sweden (Sverigetopplistan)[77]
62
Switzerland (Schweizer Hitparade)[78]
56
UK Singles (Official Charts Company)[79]
27
US Billboard Hot 100[80]
52
US Adult Top 40 (Billboard)[81]
29
US Mainstream Top 40 (Billboard)[82]
36
Chart (2015)
Position
Canada (Canadian Hot 100)[83]
72
US Billboard Hot 100[84]
92
US Adult Top 40 (Billboard)[85]
49
US Mainstream Top 40 (Billboard)[86]
49
Certifications and sales[edit]
Region
Certification
Certified units/Sales
Australia (ARIA)[87]
2× Platinum 140,000^
Canada (Music Canada)[88]
4× Platinum 320,000^
Germany (BVMI)[89]
Gold 200,000^
Italy (FIMI)[90]
2× Platinum 60,000
New Zealand (RMNZ)[91]
Platinum 15,000*
Sweden (GLF)[92]
Platinum 40,000^
Switzerland (IFPI Switzerland)[93]
Gold 15,000^
United Kingdom (BPI)[94]
Platinum 399,000[23]
United States (RIAA)[95]
3× Platinum 1,464,000[25]
Streaming
Denmark (IFPI Denmark)[96]
Platinum 2,600,000^
*sales figures based on certification alone
^shipments figures based on certification alone
sales+streaming figures based on certification alone
Release history[edit]
Region
Date
Format
United Kingdom[97]
14 August 2014 Contemporary hit radio
References[edit]
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Jump up ^ Lee, Ashley (30 May 2014). "Ed Sheeran Debuts Cheating Song 'Don't' in Beats by Dre Ad (Watch)". Billboard. Retrieved 9 December 2014.
^ Jump up to: a b Menyes, Carolyn. "Ed Sheeran New Single 'Don't' Probably Touches on Ellie Goulding Cheating in the Most Grooving Way Possible". Music Times. Retrieved 24 June 2014.
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^ Jump up to: a b c d Garibaldi, Christina (16 May 2014). "Don't Get Ed Sheeran Mad - He Might Write A Song About You". MTV. Retrieved 4 November 2015.
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^ Jump up to: a b c Kennedy, John (23 June 2014). "VIBE Summer 2014 Cover Story: Ed Sheeran". Vibe. Retrieved 4 November 2015.
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Jump up ^ "American single certifications – Ed Sheeran – Don't". Recording Industry Association of America. Retrieved 1 August 2014. If necessary, click Advanced, then click Format, then select Single, then click SEARCH
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External links[edit]
Music video on YouTube
Audio on YouTube
Lyrics of this song at MetroLyrics
[hide]
v
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e
Ed Sheeran songs
Discography
+
"The A Team"
"Drunk"
"Small Bump"
"Lego House"
"You Need Me, I Don't Need You"
"Give Me Love"
"The Parting Glass"
x
"One"
"I'm a Mess"
"Sing"
"Don't"
"Photograph"
"Bloodstream"
"Tenerife Sea"
"The Man"
"Thinking Out Loud"
"Afire Love"
÷
"Eraser"
"Castle on the Hill"
"Dive"
"Shape of You"
"Perfect"
"Galway Girl"
"Happier"
"New Man"
"What Do I Know?"
"How Would You Feel (Paean)"
"Supermarket Flowers"
"Nancy Mulligan"
Featured songs
"All About It"
"Do They Know It's Christmas?"
"Dreamers"
"Everything Has Changed"
"Hush Little Baby"
"If I Could"
"Lay It All on Me"
"Old School Love"
"Reuf"
"Teardrop"
"Watchtower"
"Young Guns"
"Boa Me"
"End Game"
"River"
Other songs
"All of the Stars"
"Candle in the Wind"
"I See Fire"
"Make It Rain"
Category
Retrieved from "https://en.wikipedia.org/w/index.php?title=Don%27t_(Ed_Sheeran_song)&oldid=822659467"
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Hypoxia (medical)
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
A condition in which the body or a region of the body is deprived of adequate oxygen at the tissue level
Hypoxia
Synonyms
Hypoxiation
Cyanosis of the hand in an elderly person with low oxygen saturation
Classification and external resources
Specialty
Pulmonology, toxicology
ICD-10
J96
ICD-9-CM
799.02
DiseasesDB
6623
MeSH
D000860
[edit on Wikidata]
Hypoxia[1] is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during hypoventilation training[2] or strenuous physical exercise.
Hypoxia differs from hypoxemia and anoxemia in that hypoxia refers to a state in which oxygen supply is insufficient, whereas hypoxemia and anoxemia refer specifically to states that have low or zero arterial oxygen supply.[3] Hypoxia in which there is complete deprivation of oxygen supply is referred to as anoxia.
Generalized hypoxia occurs in healthy people when they ascend to high altitude, where it causes altitude sickness leading to potentially fatal complications: high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE).[4] Hypoxia also occurs in healthy individuals when breathing mixtures of gases with a low oxygen content, e.g. while diving underwater especially when using closed-circuit rebreather systems that control the amount of oxygen in the supplied air. Mild, non-damaging intermittent hypoxia is used intentionally during altitude training to develop an athletic performance adaptation at both the systemic and cellular level.[5]
Hypoxia is a common complication of preterm birth in newborn infants. Because the lungs develop late in pregnancy, premature infants frequently possess underdeveloped lungs. To improve lung function, doctors frequently place infants at risk of hypoxia inside incubators (also known as humidicribs) that provide continuous positive airway pressure.[citation needed]
Contents
1 Generalized hypoxia
2 Local hypoxia
3 Cause
3.1 Ischemia
3.2 Hypoxemic hypoxia
3.2.1 Carbon monoxide poisoning
3.2.2 Altitude
3.2.3 Hypoxic breathing gases
3.2.4 Other
3.3 Anemia
3.4 Histotoxic hypoxia
3.4.1 Cyanide poisoning
4 Physiological compensation
4.1 Acute
4.2 Chronic
5 Treatment
6 See also
7 References
8 External links
Generalized hypoxia[edit]
The symptoms of generalized hypoxia depend on its severity and acceleration of onset.
In the case of altitude sickness, where hypoxia develops gradually, the symptoms include fatigue, numbness / tingling of extremities, nausea, and anoxia.[6][7] These symptoms are often difficult to identify, but early detection of symptoms can be critical.[7]
In severe hypoxia, or hypoxia of very rapid onset, ataxia, confusion / disorientation / hallucinations / behavioral change, severe headaches / reduced level of consciousness, papilloedema, breathlessness,[6] pallor,[8] tachycardia, and pulmonary hypertension eventually leading to the late signs cyanosis, slow heart rate / cor pulmonale, and low blood pressure followed by death.[9][10]
Because hemoglobin is a darker red when it is not bound to oxygen (deoxyhemoglobin), as opposed to the rich red color that it has when bound to oxygen (oxyhemoglobin), when seen through the skin it has an increased tendency to reflect blue light back to the eye.[11] In cases where the oxygen is displaced by another molecule, such as carbon monoxide, the skin may appear 'cherry red' instead of cyanotic.[12] Hypoxia can cause premature birth, and injure the liver, among other deleterious effects.
Local hypoxia[edit]
If tissue is not being perfused properly, it may feel cold and appear pale; if severe, hypoxia can result in cyanosis, a blue discoloration of the skin. If hypoxia is very severe, a tissue may eventually become gangrenous. Extreme pain may also be felt at or around the site.[citation needed]
Tissue hypoxia from low oxygen delivery may be due to low haemoglobin concentration (anaemic hypoxia), low cardiac output (stagnant hypoxia) or low haemoglobin saturation (hypoxic hypoxia).[13] The consequence of oxygen deprivation in tissues is a switch to anaerobic metabolism at the cellular level. As such, reduced systemic blood flow may result in increased serum lactate.[14] Serum lactate levels have been correlated with illness severity and mortality in critically ill adults and in ventilated neonates with respiratory distress.[14]
Cause[edit]
Oxygen passively diffuses in the lung alveoli according to a pressure gradient. Oxygen diffuses from the breathed air, mixed with water vapour, to arterial blood, where its partial pressure is around 100 mmHg (13.3 kPa).[15] In the blood, oxygen is bound to hemoglobin, a protein in red blood cells. The binding capacity of hemoglobin is influenced by the partial pressure of oxygen in the environment, as described in the oxygen–hemoglobin dissociation curve. A smaller amount of oxygen is transported in solution in the blood.
In peripheral tissues, oxygen again diffuses down a pressure gradient into cells and their mitochondria, where it is used to produce energy in conjunction with the breakdown of glucose, fats, and some amino acids.[16]
Hypoxia can result from a failure at any stage in the delivery of oxygen to cells. This can include decreased partial pressures of oxygen, problems with diffusion of oxygen in the lungs, insufficient available hemoglobin, problems with blood flow to the end tissue, and problems with breathing rhythm.
Experimentally, oxygen diffusion becomes rate limiting (and lethal) when arterial oxygen partial pressure falls to 60 mmHg (5.3 kPa) or below.[citation needed]
Almost all the oxygen in the blood is bound to hemoglobin, so interfering with this carrier molecule limits oxygen delivery to the periphery. Hemoglobin increases the oxygen-carrying capacity of blood by about 40-fold,[17] with the ability of hemoglobin to carry oxygen influenced by the partial pressure of oxygen in the environment, a relationship described in the oxygen–hemoglobin dissociation curve. When the ability of hemoglobin to carry oxygen is interfered with, a hypoxic state can result.[18]:997–999
Ischemia[edit]
Main article: Ischemia
Ischemia, meaning insufficient blood flow to a tissue, can also result in hypoxia. This is called 'ischemic hypoxia'. This can include an embolic event, a heart attack that decreases overall blood flow, or trauma to a tissue that results in damage. An example of insufficient blood flow causing local hypoxia is gangrene that occurs in diabetes.[citation needed]
Diseases such as peripheral vascular disease can also result in local hypoxia. For this reason, symptoms are worse when a limb is used. Pain may also be felt as a result of increased hydrogen ions leading to a decrease in blood pH (acidity) created as a result of anaerobic metabolism.[citation needed]
Hypoxemic hypoxia[edit]
Main article: Hypoxemia
This refers specifically to hypoxic states where the arterial content of oxygen is insufficient.[19] This can be caused by alterations in respiratory drive, such as in respiratory alkalosis, physiological or pathological shunting of blood, diseases interfering in lung function resulting in a ventilation-perfusion mismatch, such as a pulmonary embolus, or alterations in the partial pressure of oxygen in the environment or lung alveoli, such as may occur at altitude or when diving.
Carbon monoxide poisoning[edit]
Main article: Carbon monoxide poisoning
Carbon monoxide competes with oxygen for binding sites on hemoglobin molecules. As carbon monoxide binds with hemoglobin hundreds of times tighter than oxygen, it can prevent the carriage of oxygen.[20] Carbon monoxide poisoning can occur acutely, as with smoke intoxication, or over a period of time, as with cigarette smoking. Due to physiological processes, carbon monoxide is maintained at a resting level of 4–6 ppm. This is increased in urban areas (7–13 ppm) and in smokers (20–40 ppm).[21] A carbon monoxide level of 40 ppm is equivalent to a reduction in hemoglobin levels of 10 g/L.[21][22]
CO has a second toxic effect, namely removing the allosteric shift of the oxygen dissociation curve and shifting the foot of the curve to the left. In so doing, the hemoglobin is less likely to release its oxygens at the peripheral tissues.[23] Certain abnormal hemoglobin variants also have higher than normal affinity for oxygen, and so are also poor at delivering oxygen to the periphery.
Altitude[edit]
Main article: Altitude sickness
Atmospheric pressure reduces with altitude and with it, the amount of oxygen.[24][25] The reduction in the partial pressure of inspired oxygen at higher altitudes lowers the oxygen saturation of the blood, ultimately leading to hypoxia.[26] The clinical features of altitude sickness include: sleep problems, dizziness, headache and oedema.[27]i[28]
Hypoxic breathing gases[edit]
Main articles: Inert gas asphyxiation and Asphyxiant gases
The breathing gas in scuba diving may contain an insufficient partial pressure of oxygen, particularly in malfunction of rebreathers. Such situations may lead to unconsciousness without symptoms since carbon dioxide levels are normal and the human body senses pure hypoxia poorly.
A similar problem exists when inhaling certain odorless asphyxiant gases. Asphyxiant gases reduce/displace the normal oxygen concentration in breathing air, where prolonged exposure to this hypoxic breathing gas leads to unconsciousness, followed by death by inert gas asphyxiation (suffocation).[29] When oxygen level dips below 19.5% v/v, the air is considered oxygen-deficient, where oxygen concentrations below 16% volume are considered highly dangerous for humans.[29] As asphyxiant gases are relatively inert and odorless, their presence may not be noticed until the effects of elevated blood carbon dioxide (hypercapnia) are recognized by the body.[29] Inert gas asphyxiation may be deliberate with use of a suicide bag. Accidental death has occurred in cases where concentrations of nitrogen in controlled atmospheres, or methane in mines, has not been detected or appreciated.[30]
Other[edit]
Hemoglobin's function can also be lost by chemically oxidizing its iron atom to its ferric form. This form of inactive hemoglobin is called methemoglobin and can be made by ingesting sodium nitrite[31] as well as certain drugs and other chemicals.[32]
Anemia[edit]
Main article: Anemia
Hemoglobin plays a substantial role in carrying oxygen throughout the body,[17] and when it is deficient, anemia can result, causing 'anaemic hypoxia' if tissue perfusion is decreased. Iron deficiency is the most common cause of anemia. As iron is used in the synthesis of hemoglobin, less hemoglobin will be synthesised when there is less iron, due to insufficient intake, or poor absorption.[18]:997–999
Anemia is typically a chronic process that is compensated over time by increased levels of red blood cells via upregulated erythropoetin. A chronic hypoxic state can result from a poorly compensated anaemia.[18]:997–999
Histotoxic hypoxia[edit]
Cyanide poisoning[edit]
Histotoxic hypoxia results when the quantity of oxygen reaching the cells is normal, but the cells are unable to use the oxygen effectively as a result of disabled oxidative phosphorylation enzymes. This may occur in cyanide poisoning.[33]
Physiological compensation[edit]
Acute[edit]
If oxygen delivery to cells is insufficient for the demand (hypoxia), electrons will be shifted to pyruvic acid in the process of lactic acid fermentation. This temporary measure (anaerobic metabolism) allows small amounts of energy to be released. Lactic acid build up (in tissues and blood) is a sign of inadequate mitochondrial oxygenation, which may be due to hypoxemia, poor blood flow (e.g., shock) or a combination of both.[34] If severe or prolonged it could lead to cell death.[citation needed]
In humans, hypoxia is detected by the peripheral chemoreceptors in the carotid body and aortic body, with the carotid body chemoreceptors being the major mediators of reflex responses to hypoxia.[35] This response does not control ventilation rate at normal pO
2, but below normal the activity of neurons innervating these receptors increases dramatically, so much so to override the signals from central chemoreceptors in the hypothalamus, increasing pO
2 despite a falling pCO2
It is seen in a few humans (encountered with hypoxia), there is word loss in their speech due to their state of confusion and cell damage in the brain.
In most tissues of the body, the response to hypoxia is vasodilation. By widening the blood vessels, the tissue allows greater perfusion.
By contrast, in the lungs, the response to hypoxia is vasoconstriction. This is known as hypoxic pulmonary vasoconstriction, or "HPV".[36]
Chronic[edit]
When the pulmonary capillary pressure remains elevated chronically (for at least 2 weeks), the lungs become even more resistant to pulmonary edema because the lymph vessels expand greatly, increasing their capability of carrying fluid away from the interstitial spaces perhaps as much as 10-fold. Therefore, in patients with chronic mitral stenosis, pulmonary capillary pressures of 40 to 45 mm Hg have been measured without the development of lethal pulmonary edema.[Guytun and Hall physiology]
Hypoxia exists when there is a reduced amount of oxygen in the tissues of the body. Hypoxemia refers to a reduction in PO2 below the normal range, regardless of whether gas exchange is impaired in the lung, CaO2 is adequate, or tissue hypoxia exists. There are several potential physiologic mechanisms for hypoxemia, but in patients with COPD the predominant one is V/Q mismatching, with or without alveolar hypoventilation, as indicated by PaCO2. Hypoxemia caused by V/Q mismatching as seen in COPD is relatively easy to correct, so that only comparatively small amounts of supplemental oxygen (less than 3 L/min for the majority of patients) are required for LTOT. Although hypoxemia normally stimulates ventilation and produces dyspnea, these phenomena and the other symptoms and signs of hypoxia are sufficiently variable in patients with COPD as to be of limited value in patient assessment. Chronic alveolar hypoxia is the main factor leading to development of cor pulmonale—right ventricular hypertrophy with or without overt right ventricular failure—in patients with COPD. Pulmonary hypertension adversely affects survival in COPD, to an extent that parallels the degree to which resting mean pulmonary artery pressure is elevated. Although the severity of airflow obstruction as measured by FEV1 is the best correlate with overall prognosis in patients with COPD, chronic hypoxemia increases mortality and morbidity for any severity of disease. Large-scale studies of LTOT in patients with COPD have demonstrated a dose-response relationship between daily hours of oxygen use and survival. There is reason to believe that continuous, 24-hours-per-day oxygen use in appropriately selected patients would produce a survival benefit even greater than that shown in the NOTT and MRC studies.[37]
Treatment[edit]
To counter the effects of high-altitude diseases, the body must return arterial pO
2 toward normal. Acclimatization, the means by which the body adapts to higher altitudes, only partially restores pO
2 to standard levels. Hyperventilation, the body’s most common response to high-altitude conditions, increases alveolar pO
2 by raising the depth and rate of breathing. However, while pO
2 does improve with hyperventilation, it does not return to normal. Studies of miners and astronomers working at 3000 meters and above show improved alveolar pO
2 with full acclimatization, yet the pO
2 level remains equal to or even below the threshold for continuous oxygen therapy for patients with chronic obstructive pulmonary disease (COPD).[38] In addition, there are complications involved with acclimatization. Polycythemia, in which the body increases the number of red blood cells in circulation, thickens the blood, raising the danger that the heart can’t pump it.
In high-altitude conditions, only oxygen enrichment can counteract the effects of hypoxia. By increasing the concentration of oxygen in the air, the effects of lower barometric pressure are countered and the level of arterial pO
2 is restored toward normal capacity. A small amount of supplemental oxygen reduces the equivalent altitude in climate-controlled rooms. At 4000 m, raising the oxygen concentration level by 5 percent via an oxygen concentrator and an existing ventilation system provides an altitude equivalent of 3000 m, which is much more tolerable for the increasing number of low-landers who work in high altitude.[39] In a study of astronomers working in Chile at 5050 m, oxygen concentrators increased the level of oxygen concentration by almost 30 percent (that is, from 21 percent to 27 percent). This resulted in increased worker productivity, less fatigue, and improved sleep.[38]
Oxygen concentrators are uniquely suited for this purpose. They require little maintenance and electricity, provide a constant source of oxygen, and eliminate the expensive, and often dangerous, task of transporting oxygen cylinders to remote areas. Offices and housing already have climate-controlled rooms, in which temperature and humidity are kept at a constant level. Oxygen can be added to this system easily and relatively cheaply.[citation needed]
A prescription renewal for home oxygen following hospitalization requires an assessment of the patient for ongoing hypoxemia.[40]
See also[edit]
Asphyxia
Autoerotic hypoxia or erotic asphyxiation, intentional restriction of oxygen to the brain for sexual arousal
Cerebral hypoxia or cerebral anoxia, a reduced supply of oxygen to the brain
Fink effect, or diffusion hypoxia, a factor that influences the partial pressure of oxygen within the pulmonary alveolus
G-LOC cerebral hypoxia induced by excessive g-forces
Histotoxic hypoxia, the inability of cells to take up or utilize oxygen from the bloodstream
Hyperoxia
Hypoventilation training
Hypoxic drive, a respiratory drive in which the body uses oxygen chemoreceptors to regulate the respiratory cycle
Hypoxemia or hypoxemic hypoxia, a deficiency of oxygen in arterial blood
Hypoxic hypoxia, a result of insufficient oxygen available to the lungs
Hypoxia in fish, responses of fish to hypoxia
Hypoxic ventilatory response
Hypoxicator a device intended for hypoxia acclimatisation in a controlled manner
Intrauterine hypoxia, when a fetus is deprived of an adequate supply of oxygen
Intermittent hypoxic training
Latent hypoxia or deep water blackout, loss of consciousness on ascending from a deep freedive
Pseudohypoxia, increased cytosolic ratio of free NADH to NAD+ in cells
Sleep apnea
Time of useful consciousness
Tumor hypoxia, the situation where tumor cells have been deprived of oxygen
Rhinomanometry
References[edit]
Jump up ^ Samuel, Jacob; Franklin, Cory (2008). Common Surgical Diseases. New Yotk: Springer. pp. 391–94. doi:10.1007/978-0-387-75246-4_97. ISBN 9780387752457.
Jump up ^ Woorons, Xavier, Hypoventilation training, push your limits! Arpeh, 2014, 164 pp. ISBN 978-2-9546040-1-5
Jump up ^ West, John B. (1977). Pulmonary Pathophysiology: The Essentials. Williams & Wilkins. p. 22. ISBN 978-0-683-08936-3.
Jump up ^ Cymerman, A; Rock, PB. "Medical Problems in High Mountain Environments. A Handbook for Medical Officers". USARIEM-TN94-2. US Army Research Inst. of Environmental Medicine Thermal and Mountain Medicine Division Technical Report. Retrieved 2009-03-05.
Jump up ^ Gore CJ, Clark SA, Saunders PU (September 2007). "Nonhematological mechanisms of improved sea-level performance after hypoxic exposure". Med Sci Sports Exerc. 39 (9): 1600–09. doi:10.1249/mss.0b013e3180de49d3. PMID 17805094.
^ Jump up to: a b Robinson, Grace; Strading, John; West, Sophie (2009). Oxford Handbook of Respiratory Medicine. Oxford University Press. p. 880. ISBN 978-0199545162.
^ Jump up to: a b Bergqvist, Pia (15 April 2015). "Preventing Hypoxia: What To Do Now". Flying. Retrieved 22 April 2015.
Jump up ^ Illingworth, Robin; Graham, Colin; Hogg, Kerstin (2012). Oxford Handbook of Emergency Medicine. Oxford University Press. p. 768. ISBN 978-0199589562.
Jump up ^ Hillman, Ken; Bishop, Gillian (2004). Clinical Intensive Care and Acute Medicine. Cambridge University Press. p. 685. ISBN 978-1139449366.
Jump up ^ Longmore, J.; Longmore, Murray; Wilkinson, Ian; Rajagopalan, Supraj (2006). Mini Oxford Handbook of Clinical Medicine. Oxford University Press. p. 874. ISBN 978-0198570714.
Jump up ^ Ahrens, Thomas; Rutherford Basham, Kimberley (1993). Essentials of Oxygenation: Implication for Clinical Practice. Jones & Bartlett Learning. p. 194. ISBN 978-0867203325.
Jump up ^ Ramrakha, Punit; Moore, Kevin (2004). Oxford Handbook of Acute Medicine. Oxford University Press. p. 990. ISBN 978-0198520726.
Jump up ^ Lacroix, Jacques; Tucci, Marisa; Tinmouth, Alan; Gauvin, France; Karam, Oliver (2011). Pediatric Critical Care. Elsevier. pp. 1162–76. doi:10.1016/b978-0-323-07307-3.10082-5. ISBN 9780323073073.
^ Jump up to: a b Kluckow, Martin; Seri, Istvan (2012). Hemodynamics and Cardiology: Neonatology Questions and Controversies. Elsevier. pp. 237–67. doi:10.1016/b978-1-4377-2763-0.00012-3. ISBN 9781437727630.
Jump up ^ Kenneth Baillie; Alistair Simpson. "Altitude oxygen calculator". Apex (Altitude Physiology Expeditions). Retrieved 2006-08-10. – Online interactive oxygen delivery calculator.
Jump up ^ Jae-Hwan, Lee; Eun-Kyeong, Shin; Dongoh, Lee; Eui-Bae, Jeung (April 2015). "SAT-532: Expression of Beta-Oxidation Related Genes Under Hypoxic Condition Induced Preeclamptic Model in Vitro and in Vivo". Endocrine Reviews. 36 (2). doi:10.1210/endo-meetings.2015.CE.4.SAT-532 (inactive 2018-09-21). Retrieved 11 November 2016.
^ Jump up to: a b Martin, Lawrence (1999). All you really need to know to interpret arterial blood gases (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. ISBN 978-0-683-30604-0.
^ Jump up to: a b c Nicki R. Colledge; Brian R. Walker; Stuart H. Ralston, eds. (2010). Davidson's principles and practice of medicine. illustrated by Robert Britton (21st ed.). Edinburgh: Churchill Livingstone/Elsevier. ISBN 978-0-7020-3085-7.
Jump up ^ West, John B. (2008). Respiratory Physiology: The Essentials (8th ed.). La Jolla: Wolters Kluwer Lippincott Williams & Wilkins. pp. 88–89.
Jump up ^ Douglas CG, Haldane JS, Haldane JB (Jun 12, 1912). "The laws of combination of hemoglobin with carbon monoxide and oxygen". The Journal of Physiology. 44 (4): 275–304. doi:10.1113/jphysiol.1912.sp001517. PMC 1512793. PMID 16993128.
^ Jump up to: a b Wald, NJ; Idle, M; Boreham, J; Bailey, A (May 1981). "Carbon monoxide in breath in relation to smoking and carboxyhaemoglobin levels". Thorax. 36 (5): 366–69. doi:10.1136/thx.36.5.366. PMC 471511. PMID 7314006.
Jump up ^ The formula H b C O ( % ) = C O − 2.34 5.09 {\displaystyle Hb_{CO}(\%)={\frac {CO-2.34}{5.09}}} can be used to calculate the amount of carbon monoxide-bound hemoglobin. For example, at carbon monoxide level of 5 ppm, = 5 − 2.34 5.09 = .5 % {\displaystyle ={\frac {5-2.34}{5.09}}=.5\%} , or a loss of half a percent of their blood's hemoglobin. (Wald et al., 1981)
Jump up ^ Martin, Lawrence. (1992) All you really need to know to interpret arterial blood gases. 2nd edition ISBN 0-683-30604-9
Jump up ^ Netzer, Nikolaus; Strohl, Kingman; Faulhaber, Martin; Gatterer, Hannes; Burtscher, Martin (1 July 2013). "Hypoxia‐Related Altitude Illnesses". Journal of Travel Medicine. 20 (4): 247–55. doi:10.1111/jtm.12017. PMID 23809076.
Jump up ^ Netzer, Nikolaus; Strohl, Kingman; Faulhaber, Martin; Gatterer, Hannes; Burtscher, Martin (1 July 2013). "Hypoxia‐Related Altitude Illnesses". Journal of Travel Medicine. 20 (4): 247–55. doi:10.1111/jtm.12017. PMID 23809076.
Jump up ^ Netzer, Nikolaus; Strohl, Kingman; Faulhaber, Martin; Gatterer, Hannes; Burtscher, Martin (1 July 2013). "Hypoxia‐Related Altitude Illnesses". Journal of Travel Medicine. 20 (4): 247–55. doi:10.1111/jtm.12017. PMID 23809076.
Jump up ^ Netzer, Nikolaus; Strohl, Kingman; Faulhaber, Martin; Gatterer, Hannes; Burtscher, Martin (1 July 2013). "Hypoxia‐Related Altitude Illnesses". Journal of Travel Medicine. 20 (4): 247–55. doi:10.1111/jtm.12017. PMID 23809076.
Jump up ^ Netzer, Nikolaus; Strohl, Kingman; Faulhaber, Martin; Gatterer, Hannes; Burtscher, Martin (1 July 2013). "Hypoxia‐Related Altitude Illnesses". Journal of Travel Medicine. 20 (4): 247–55. doi:10.1111/jtm.12017. PMID 23809076.
^ Jump up to: a b c Sensidyne. "What is an Asphyxiant? | Sensidyne". www.sensidynegasdetection.com. Retrieved 2018-04-28.
Jump up ^ Milroy, Christopher (Autumn 2018). "Deaths from Environmental Hypoxia and Raised Carbon Dioxide". Academic Forensic Pathology. 8: 2–7. doi:10.23907/2018.001.
Jump up ^ Roueché, Berton (1953) Eleven blue men, and other narratives of medical detection. Boston: Little, Brown.
Jump up ^ Seneff, Stephanie; Swanson, Nancy; Li, Chen (2015) Aluminum and Glyphosate Can Synergistically Induce Pineal Gland Pathology: Connection to Gut Dysbiosis and Neurological Disease. Agricultural Sciences, 2015, 6, 42–70. [1]
Jump up ^ Pittman, RN (2011). "Regulation of Tissue Oxygenation". Morgan & Claypool Life Sciences. p. Chapter 7.
Jump up ^ Hobler, K.E.; L.C. Carey (1973). "Effect of acute progressive hypoxemia on cardiac output and plasma excess lactate". Ann Surg. 177 (2): 199–202. doi:10.1097/00000658-197302000-00013. PMC 1355564. PMID 4572785.
Jump up ^ Arieff, Allen I. (2013). Hypoxia, Metabolic Acidosis, and the Circulation. Springer. pp. 4–5. ISBN 978-1461475422.
Jump up ^ Michiels, Carine (2004). "Physiological and Pathological Responses to Hypoxia". The American Journal of Pathology. 164 (6): 1875–82. doi:10.1016/S0002-9440(10)63747-9. PMC 1615763. PMID 15161623.
Jump up ^ Pierson, D. J. (2000). "Pathophysiology and clinical effects of chronic hypoxia". Respir Care. 45 (1): 39–51, discussion 51–3. PMID 10771781.
^ Jump up to: a b West, John B.; American College Of Physicians; American Physiological Society (2004). "The Physiologic Basis of High-Altitude Diseases". Annals of Internal Medicine. 141 (10): 789–800. doi:10.7326/0003-4819-141-10-200411160-00010. PMID 15545679.
Jump up ^ West, John B. (1995). "Oxygen Enrichment of Room Air to Relieve the Hypoxia of High Altitude". Respiration Physiology. 99 (2): 225–32. doi:10.1016/0034-5687(94)00094-G. PMID 7777705.
Jump up ^ American College of Chest Physicians; American Thoracic Society (September 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American College of Chest Physicians and American Thoracic Society, retrieved 6 January 2013
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ro
ro
interlanguage-link-target

values:
interlanguage-link interwiki-ro
display: none;

values: Гипоксия – Russian

values:
https://sl.wikipedia.org/wiki/Hipoksija
Hipoksija – Slovenian
sl
sl
interlanguage-link-target

values:
interlanguage-link interwiki-sl
display: none;

values: Хипоксија – Serbian

values:
interlanguage-link interwiki-sr
display: none;

values:
https://sh.wikipedia.org/wiki/Hipoksija
Hipoksija – Serbo-Croatian
sh
sh
interlanguage-link-target

values:
interlanguage-link interwiki-sh
display: none;

values:
https://fi.wikipedia.org/wiki/Hypoksia
Hypoksia – Finnish
fi
fi
interlanguage-link-target

values:
interlanguage-link interwiki-fi
display: none;

values:
https://sv.wikipedia.org/wiki/Hypoxi
Hypoxi – Swedish
sv
sv
interlanguage-link-target

values:
interlanguage-link interwiki-sv
display: none;

values: தாழாக்சியம் – Tamil

values:
interlanguage-link interwiki-ta
display: none;

values:
interlanguage-link interwiki-tr
display: none;

values: Гіпоксія – Ukrainian

values:
interlanguage-link interwiki-uk
display: none;

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-Hypoxia_medical rootpage-Hypoxia_medical skin-vector action-view