Refractory hypoxemia is a medical condition where a person's blood oxygen levels remain dangerously low despite providing them with high levels of supplemental oxygen. This condition occurs due to various factors, such as ventilation-perfusion mismatch, shunt, diffusion impairment, low cardiac output, or diffusion limitation. Refractory hypoxemia is considered a severe form of hypoxemia, which can lead to organ failure and even death if not treated promptly. Common causes of refractory hypoxemia include acute respiratory distress syndrome (ARDS), pneumonia, sepsis, lung injury, and acute respiratory failure. Treatment usually involves increasing the supplied oxygen level to achieve adequate oxygenation levels, using positive airway pressure, or mechanical ventilation. In severe cases, extracorporeal membrane oxygenation (ECMO) may be needed to support the patient's oxygenation until the underlying condition is treated.
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