Acute Hypoxemia
From confirming true hypoxemia to identifying the underlying mechanism.
An educational representation of clinical reasoning, not a diagnostic algorithm or personalized medical advice — always apply clinical judgment and institutional protocols.
Caution
Escalate — Red Flags & Critical Warnings
- SpO2 < 90% despite high-flow supplemental oxygen with increasing work of breathing — prepare for advanced airway management rather than continuing to escalate oxygen alone.
- New unilateral absent breath sounds with hypotension — assess for tension pneumothorax immediately; do not wait for imaging.
Related Bedside Clinical Problems (13)
Bedside PresentationsBedside triage of acute desaturation: signal verification, immediate danger screening (DOPE / tension pneumothorax), oxygen escalation ladder, and mechanism-based differential.
Triaging rising PaCO2: distinguishing acute uncompensated acidemia from chronic compensation, identifying central vs pump vs dead-space failure, and titrating noninvasive ventilation.
Algorithmic troubleshooting of acute patient-ventilator collapse: the DOPE framework, peak vs plateau pressure differentiation, auto-PEEP evaluation, and manual bagging separation.
Linked Deep-Dive Topics (7)
Reference KnowledgePathophysiologic mechanisms (shunt vs V/Q mismatch), dynamic ROX index trajectories, P-SILI prevention, and evidence-based oxygen escalation ladders.
Acute, diffuse inflammatory lung injury causing hypoxemia and bilateral infiltrates not fully explained by cardiac failure or fluid overload.
Hydrostatic pulmonary edema physiology, SCAPE vs decompensated HF vs cardiogenic shock, NIV, titrated vasodilators when hypertensive, diuresis, and sequential nephron blockade.
Core taxonomy (Types I–IV), alveolar gas exchange physiology, work-of-breathing mechanics, and escalation thresholds in acute respiratory failure.
Pulmonary vascular occlusion, acute RV pressure overload, ESC/AHA risk stratification, systemic thrombolysis, catheter-directed therapies, and hemodynamic support.
IDSA/ATS severe CAP criteria, rapid microbiology, targeted empiric antimicrobial regimens, and landmark adjunctive hydrocortisone evidence (CAPE COD).
Tension physiology, point-of-care ultrasound diagnosis, needle/finger/tube thoracostomy, and management of bronchopleural fistulas on mechanical ventilation.
Evidence status
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