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Oxygen toxicity or oxygen toxicity syndrome (also known as the "Paul Bert effect") is severe hyperoxia caused by breathing oxygen at elevated partial pressures. The high concentration of oxygen damages cells. The precise mechanism(s) of the damage are not known, but oxygen gas has a propensity to react with certain metals to form superoxide which may attack double bonds in many organic systems, including the unsaturated fatty acid residues in cells. High concentrations of oxygen are known to increase the formation of cascades of such free-radicals in biological systems, at which in many then go on to directly harm DNA and other structures (see nitric oxide, peroxynitrite, and trioxidane). Normally, the body has many defense systems against such damage (see glutathione, catalase, and superoxide dismutase) but at higher concentrations of free oxygen, these systems are eventually overwhelmed with time, and the rate of damage to cell membranes exceeds the capacity of systems which control or repair it. Cell damage and cell death then results.
Types of oxygen toxicity In humans, there are several types of oxygen toxicity:
At sea-level, 0.5 bar is exceeded by gas mixtures having oxygen fractions greater than 50%. Lung oxygen toxicity damage-rates at sea-level pressure rise non-linearly between the 50% threshold of toxicity, and the rate of damage on 100% oxygen. For this reason, intensive care patients requiring more than 60% oxygen, and especially patients at fractions near 100% oxygen, are considered to be at especially high risk, since if the situation is not corrected, the treatment may begin to cause lung damage which contributes to need for the high-oxygen mixture.
Care must be used in distinguishing oxygen mole fraction from oxygen partial pressure. As noted earlier in this article, the toxicity is from high partial pressure. This is illustrated by oxygen use in spacesuits and other low-pressure applications (historically, for example, the Gemini spacecraft and Apollo spacecraft). High fraction oxygen is non-toxic even at breathing mixture oxygen fractions approaching 100%, because the oxygen partial pressure is not allowed to chronically exceed 0.35 bar in these applications.
Hyperoxia Hyperoxia is excess oxygen in body tissues or higher than normal partial pressure of oxygen. Hyperoxia is caused by breathing gas at pressures greater than normal atmospheric pressure or by breathing oxygen-rich gases at normal atmospheric pressure for a prolonged period of time.
Common causes The oxygen toxicity syndrome may occur
Avoiding oxygen toxicity while diving CNS oxygen toxicity is a deadly but entirely avoidable event while diving. The diver generally experiences no warning signs because the brain primarily monitors carbon dioxide levels. The symptoms are sudden convulsions and unconsciousness, during which the victim will lose his regulator and drown. There is an increased risk of CNS oxygen toxicity on deep dives, long dives or dives where oxygen-rich breathing gases are used.In some diver training courses for these types of diving, divers are taught to plan and monitor what is called the "oxygen clock" of their dives. This clock is a notional alarm clock, which "ticks" more quickly at increased ppO2 and is set to activate at the maximum single exposure limits recommended in the NOAA Diving Manual stated in the Types of Oxygen Toxicity section of this article. Many Nitrox-capable dive computers also calculate this "Oxygen Loading".The aim is to avoid activating the alarm by reducing the ppO2 of the breathing gas or the length of time breathing gas of higher ppO2. As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive, the diver can obtain more time on the oxygen clock by diving at a shallower depth, by breathing a less oxygen-rich gas or by shortening the exposure to oxygen-rich gases.
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