Hyperoxia

Hyperoxia occurs when cells, tissues and organs are exposed to an excess supply of
Hyperoxia
oxygen (O2) or higher than normal partial pressure of oxygen.[1]

In medicine, it refers to excess oxygen in thelungs or other body tissues, which can be caused by breathing air or oxygen at pressures
greater than normal atmospheric pressure. This kind of hyperoxia can lead to oxygen toxicity, caused from the harmful effects of
breathing molecular oxygen at elevated partial pressures. Hyperoxia is the opposite of hypoxia; hyperoxia refers to a state in which
oxygen supply is excessive, and hypoxia refers to a state in which oxygen supply is insuf
ficient.

In the environment, it refers to excess oxygen in a body of water or other habitat.

Contents
Signs and symptoms
Oxygen toxicity
Cause
Diagnosis
Treatment
See also
References

Signs and symptoms

Associated with hyperoxia is an increased level of reactive oxygen species (ROS), which are chemically reactive molecules
containing oxygen. These oxygen containing molecules can damage lipids, proteins, and nucleic acids, and react with surrounding
biological tissues. The human body has naturally occurring antioxidants to combat reactive molecules, but the protective antioxidant
oxidation of the tissues and organs.[1]
defenses can become depleted by abundant reactive oxygen species, resulting in

The symptoms produced from breathing high concentrations of oxygen for extended periods have been studied in a variety of
animals, such as frogs, turtles, pigeons, mice, rats, guinea pigs, cats, dogs and monkeys. The majority of these studies reported the
[2]
occurrence of irritation, congestion and edema of the lungs, and even death following prolonged exposures.

Oxygen toxicity
The supplementation of oxygen can lead to oxygen toxicity, also known as oxygen toxicity syndrome, oxygen intoxication, and
oxygen poisoning. There are two main types of oxygen toxicity: central nervous system toxicity (CNS), and pulmonary and ocular
toxicity.[3]

Temporary exposure to high partial pressures of oxygen at greater than atmospheric pressure can lead to central nervous system
toxicity (CNS). An early but serious sign of CNS oxygen toxicity is a grand-mal seizure, also known as a generalized tonic-clonic
seizure. This type of seizure consists of a loss of consciousness and violent muscle contractions. Signs and symptoms of oxygen
toxicity are usually prevalent, but there are no standard warning signs that a seizure is about to ensue. The convulsion caused by
oxygen toxicity does not lead to hypoxia, a side effect common to most seizures, because the body has an excess amount of oxygen
, if the convulsion is suffered by a diver still in the water.[3]
when the convulsion begins. The seizures can lead to drowning, however
Prolonged exposure to higher oxygen levels at atmospheric pressure can lead to pulmonary and ocular toxicity. Symptoms of oxygen
toxicity may include disorientation, respiratory problems, or myopia. Prolonged exposure to higher than normal partial pressures of
oxygen can result in oxidative damage to cell membranes. Signs of pulmonary (lung) oxygen toxicity begin with slight irritation in
the trachea. A mild cough usually ensues, followed by greater irritation and a worse cough until breathing becomes quite painful and
the cough becomes uncontrollable. If supplementation of oxygen is continued, the individual will notice tightness in the chest,
[3]
difficulty breathing, shortness of breath, and if exposure is continued, fatality due to lack of oxygen.

Cause
Oxygen supplied at greater than atmospheric pressure has been known to damage plants, animals, and aerobic bacteria such as
Escherichia coli. Some studies have shown that even breathing oxygen at 21% has some damaging fects.
ef The damaging effects vary
depending on the specimen used, its age, physiological state, and diet.

The supplementation of oxygen has been a common procedure of prehospital treatment for many years. Guidelines include cautions
about chronic obstructive pulmonary disease (COPD). These guidelines stress the use of 28% oxygen masks and caution the dangers
.[4]
of hyperoxia. Long-term use of supplemental oxygen improves survival in patients with COPD, but can lead to lung injury

An additional cause of hyperoxia is related to underwater diving with breathing apparatus. Underwater divers breath a mixture of
gasses which must include oxygen, and the partial pressure of any given gas mixture will increase with depth. A mixture known as
nitrox is used to reduce the risk of decompression sickness by substituting oxygen for part of the nitrogen content. Breathing nitrox
can lead to hyperoxia due to the high partial pressure of oxygen if used too deep or for too long. Protocols for the safe use of raised
oxygen partial pressure in diving are well established and used routinely by recreational scuba divers, military combat divers and
professional saturation divers alike.[5] The highest risk of hyperoxia is in hyperbaric oxygen therapy, where it is a high probability
side effect of the treatment for more serious conditions, and is considered an acceptable risk as it can be managed effectively without
apparent long term effects.[6]

Diagnosis

Treatment
Oxygen supplementation is used to treat tissue hypoxia and to relieve arterial hypoxemia. High concentrations of oxygen are often
given to patients with chronic obstructive pulmonary disease (COPD) or acute lung injury (ALI). Supplementing oxygen is known to
cause tissue damage, with toxicity increasing with the increase of oxygen concentrations and exposure pressures. Unfortunately, the
supplementation of oxygen is necessary if an individual is not able to obtain sufficient oxygen through respiration and perfusion. To
decrease the chances of hyperoxia, the therapist should use the lowest concentration of oxygen required by an individual. At this
[7]
time, there are no known alternatives to oxygen supplementation.

See also
Hypoxia
Hypoxemia
Oxygen toxicity
Hyperbaric medicine

References
1. Mach, William J.; Thimmesch, Amanda R.; Pierce, J. Thomas; Pierce, Janet D. (2011). "Consequences of Hyperoxia
and the Toxicity of Oxygen in the Lung"(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169834). Nursing Research
and Practice. 2011: 1–7. doi:10.1155/2011/260482 (https://doi.org/10.1155%2F2011%2F260482) . PMC 3169834 (ht
tps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169834). PMID 21994818 (https://www.ncbi.nlm.nih.gov/pubmed/2199
4818).
 2. COMROE, JULIUS H. (7 July 1945). "OXYGEN T OXICITY". Journal of the American Medical Association. 128 (10):
710. doi:10.1001/jama.1945.02860270012004(https://doi.org/10.1001%2Fjama.1945.02860270012004) .
3. Sawatzky, David. "Oxygen Toxicity Signs and Symptoms"(http://www.diverite.com/education/rebreather/tips/oxyge
n%20toxicity%20signs%20and%20symptoms/) . www.diverite.com/. Retrieved 12 November 2014.
4. New, A (1 February 2006)."Oxygen: kill or cure? Prehospital hyperoxia in the COPD patient"(https://www.ncbi.nlm.n
ih.gov/pmc/articles/PMC2564043). Emergency Medicine Journal. 23 (2): 144–146. doi:10.1136/emj.2005.027458(htt
ps://doi.org/10.1136%2Femj.2005.027458). PMC 2564043
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564043). PMID 16439751 (https://www.ncbi.nlm.nih.gov/pubmed/16
439751).
5. Lang, Michael A., ed. (2001).DAN nitrox workshop proceedings(http://archive.rubicon-foundation.org/4855).
Durham, NC: Divers Alert Network. Retrieved 25 January 2017.
6. Bitterman, N (2004). "CNS oxygen toxicity" (http://archive.rubicon-foundation.org/3991). Undersea and Hyperbaric
Medicine. 31 (1): 63–72. PMID 15233161 (https://www.ncbi.nlm.nih.gov/pubmed/15233161). Retrieved 25 January
2017.
7. Jenkinson, SG (November 1993). "Oxygen toxicity".New Horizons (Baltimore, Md.). 1 (4): 504–11. PMID 8087571
(https://www.ncbi.nlm.nih.gov/pubmed/8087571).

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