Oxygen toxicity

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Obesity, Sleep & Internal medicine
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Oxygen toxicity
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Seizures, visual disturbances, tinnitus, nausea, twitching, irritability, dizziness
Complications	Lung damage, central nervous system toxicity
Onset	Minutes to hours after exposure to high partial pressure of oxygen
Duration	Variable, depending on exposure
Types	N/A
Causes	Breathing oxygen at elevated partial pressure
Risks	Hyperbaric oxygen therapy, scuba diving, mechanical ventilation
Diagnosis	Based on clinical presentation and history of exposure
Differential diagnosis	Hypoxia, carbon dioxide toxicity, decompression sickness
Prevention	Limiting exposure to high oxygen levels
Treatment	Reducing oxygen exposure, supportive care
Medication	N/A
Prognosis	Generally good if exposure is limited
Frequency	Rare in controlled settings
Deaths	N/A

Detached retina, a potential complication of oxygen toxicity.

Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen (O₂) at increased partial pressures. It is also known as oxygen poisoning or oxygen intoxication. The condition can affect the central nervous system, lungs, and eyes, and is a concern in medical, diving, and space environments.

History

Paul Bert, a pioneer in the study of oxygen toxicity.

The phenomenon of oxygen toxicity was first described by Paul Bert, a French physiologist, in the 19th century. Bert demonstrated that breathing oxygen at high pressures could lead to convulsions and other symptoms. His work laid the foundation for understanding the effects of oxygen at elevated pressures.

Mechanism

Oxygen toxicity occurs when the partial pressure of oxygen exceeds the body's ability to manage reactive oxygen species (ROS). These ROS can cause damage to cell membranes, proteins, and DNA. The primary mechanisms include:

• Central Nervous System (CNS) Toxicity: Also known as the "Paul Bert effect," CNS toxicity can lead to symptoms such as visual disturbances, nausea, twitching, irritability, and seizures.
• Pulmonary Toxicity: Also known as the "Lorrain Smith effect," this occurs with prolonged exposure to elevated oxygen levels, leading to symptoms such as coughing, difficulty breathing, and pulmonary edema.

Pathophysiology

Lipid peroxidation is a key process in oxygen toxicity.

The pathophysiology of oxygen toxicity involves oxidative stress, where an imbalance between the production of ROS and the body's ability to detoxify these reactive intermediates leads to cellular damage. Lipid peroxidation, protein oxidation, and DNA damage are critical processes in the development of oxygen toxicity.

Clinical Manifestations

Robert W. Hamilton Jr., contributed to the understanding of oxygen toxicity in diving.

Central Nervous System

CNS oxygen toxicity is characterized by symptoms such as:

• Visual disturbances
• Nausea
• Twitching
• Irritability
• Dizziness
• Seizures

Pulmonary System

Pulmonary toxicity tolerance curves.

Pulmonary oxygen toxicity can manifest as:

• Coughing
• Chest pain
• Shortness of breath
• Pulmonary edema

Ocular Effects

Oxygen toxicity can also affect the eyes, leading to conditions such as retinopathy of prematurity (ROP) in infants.

Prevention and Management

Preventing oxygen toxicity involves controlling the partial pressure of oxygen in breathing gases. In diving, this is managed by using gas mixtures with lower oxygen content, such as nitrox or trimix. In medical settings, careful monitoring of oxygen therapy is essential.

Notable Figures

• Paul Bert: Pioneered the study of oxygen toxicity.
• Robert W. Hamilton Jr.: Made significant contributions to the understanding of oxygen toxicity in diving.

See also

• Hyperbaric oxygen therapy
• Reactive oxygen species
• Diving medicine
• Retinopathy of prematurity