沈默缺氧

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沈默缺氧
类型	缺氧
风险因素	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

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]}和高山症的症狀^[15]。

診斷

「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

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

1. Tobin, Martin J.; Laghi, Franco; Jubran, Amal. Why COVID-19 Silent Hypoxemia Is Baffling to Physicians. American Journal of Respiratory and Critical Care Medicine. 2020-08-01, 202 (3) [2022-07-28]. ISSN 1073-449X. PMC 7397783 . PMID 32539537. doi:10.1164/rccm.202006-2157CP. （原始内容存档于2022-10-20） （英语）. 
2. LaMotte S. Silent hypoxia: Covid-19 patients who should be gasping for air but aren't. CNN. 7 May 2020 [2021-05-29]. （原始内容存档于2021-01-04）. 
3. Pappas S. 'Silent hypoxia' may be killing COVID-19 patients. But there's hope.. Live Science. 23 April 2020 [2021-05-29]. （原始内容存档于2020-11-27）. 
4. Three reasons why COVID-19 can cause silent hypoxia. ScienceDaily. 19 November 2020 [2021-05-29]. （原始内容存档于2020-12-29）. 
5. Emily H. Silent hypoxia and its role in COVID-19 detection. News Medical. 3 June 2020 [2021-05-29]. （原始内容存档于2020-11-29）. 
6. Chandra, Atanu; Chakraborty, Uddalak; Pal, Jyotirmoy; Karmakar, Parthasarathi. Silent hypoxia: a frequently overlooked clinical entity in patients with COVID-19. BMJ Case Reports. 2020-09, 13 (9). ISSN 1757-790X. PMC 7478026 . PMID 32900744. doi:10.1136/bcr-2020-237207 （英语）. 
7. Levitan, Richard. Opinion | The Infection That’s Silently Killing Coronavirus Patients. The New York Times. 2020-04-20 [2022-07-28]. ISSN 0362-4331. （原始内容存档于2021-01-09） （美国英语）. 
8. Silent Hypoxia Typically Not the First Symptom of COVID-19, Other Early Symptoms Should Be Monitored. American Lung Association. 15 May 2020 [2021-05-29]. （原始内容存档于2020-12-12）. 
9. COVID-19 complications: Silent hypoxia emerges as new killer in Kerala. The New Indian Express. 7 June 2020 [2021-05-29]. （原始内容存档于2020-09-25）. 
10. Study explains why Covid-19 can cause silent hypoxia. The Tribune. 30 November 2020 [2021-05-29]. （原始内容存档于2021-01-14）. 
11. Srivastava A. Blood clots in the lung may be a major cause of COVID-19 deaths. The Hindu. 23 May 2020 [2021-05-29]. （原始内容存档于2020-12-12）. 
12. Wei-Haas M. They don't struggle to breathe—but COVID-19 is starving them of oxygen. National Geographic. 8 May 2020 [2021-05-29]. （原始内容存档于2020-11-01）. 
13. Fuglebjerg, Natascha Josephine Ulstrand; Jensen, Tomas Oestergaard; Hoyer, Nils; Ryrsø, Camilla Koch; Lindegaard, Birgitte; Harboe, Zitta Barrella. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. 2020-10, 99 [2022-07-28]. PMC 7836996 . PMID 32663601. doi:10.1016/j.ijid.2020.07.014. （原始内容存档于2022-07-04） （英语）. 
14. Bowden O. What is 'silent hypoxia'? The coronavirus symptom patients don't know they have. Global News. 12 May 2020 [2021-05-29]. （原始内容存档于2021-01-07）. 
15. Ottestad, William; Søvik, Signe. COVID-19 patients with respiratory failure: what can we learn from aviation medicine?. British Journal of Anaesthesia. 2020-09, 125 (3) [2022-07-28]. PMC 7165289 . PMID 32362340. doi:10.1016/j.bja.2020.04.012. （原始内容存档于2022-08-02） （英语）. 
16. 留意「快樂缺氧」醫師教2方法 沒血氧機也能自我監測 | 生活 | 重點新聞 | 中央社 CNA. www.cna.com.tw. [2022-07-28]. （原始内容存档于2021-06-11） （中文（臺灣））. 
17. Six-Minute Walk Test. American Lung Association. [2021-05-29]. （原始内容存档于2020-10-01）. 
18. Fuglebjerg, Natascha Josephine Ulstrand; Jensen, Tomas Oestergaard; Hoyer, Nils; Ryrsø, Camilla Koch; Lindegaard, Birgitte; Harboe, Zitta Barrella. Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge. International Journal of Infectious Diseases. 2020-10-01, 99 [2022-07-28]. ISSN 1201-9712. PMC 7836996 . PMID 32663601. doi:10.1016/j.ijid.2020.07.014. （原始内容存档于2021-01-14） （英语）. 
19. Luks, Andrew M.; Swenson, Erik R. Pulse Oximetry for Monitoring Patients with COVID-19 at Home. Potential Pitfalls and Practical Guidance. Annals of the American Thoracic Society. 2020-09, 17 (9) [2022-07-28]. ISSN 2329-6933. PMC 7462317 . PMID 32521167. doi:10.1513/AnnalsATS.202005-418FR. （原始内容存档于2022-10-17） （英语）. 
20. Torjesen, Ingrid. Covid-19: Patients to use pulse oximetry at home to spot deterioration. BMJ. 2020-10-27. ISSN 1756-1833. doi:10.1136/bmj.m4151 （英语）. 
21. Teo, Jason. Early Detection of Silent Hypoxia in Covid-19 Pneumonia Using Smartphone Pulse Oximetry. Journal of Medical Systems. 2020-08, 44 (8). ISSN 0148-5598. PMC 7305055 . PMID 32562006. doi:10.1007/s10916-020-01587-6 （英语）. 
22. Brouqui, Philippe; Amrane, Sophie; Million, Matthieu; Cortaredona, Sébastien; Parola, Philippe; Lagier, Jean-Christophe; Raoult, Didier. Asymptomatic hypoxia in COVID-19 is associated with poor outcome. International Journal of Infectious Diseases. 2021-01-01, 102. ISSN 1201-9712. PMC 7604151 . PMID 33130200. doi:10.1016/j.ijid.2020.10.067 （英语）. 
23. Lari, Ali; Alherz, Mohammad; Nouri, Abdullah; Botras, Lotfi; Taqi, Salah. Caution against precaution: A case report on silent hypoxia in COVID-19. Annals of Medicine and Surgery. 2020-12-01, 60 [2022-07-28]. ISSN 2049-0801. PMC 7640922 . PMID 33169089. doi:10.1016/j.amsu.2020.11.007. （原始内容存档于2022-07-28） （英语）.