cyanosis of the newborn
Introduction
Introduction Hair blemishes, also known as cyanosis or purpura, are common symptoms of neonatal disease. Newborns are babies up to four weeks after birth. Found that newborns have symptoms of cyanosis, should immediately pay attention, timely treatment and treatment, so as not to cause the disease to deteriorate. For neonatal cyanosis, it is necessary to give oxygen-enriched treatment in time. Hair blemishes suggest hypoxia in the body, which may cause damage to vital organs such as the brain, heart, kidney, lungs, etc., which may affect their mental and physical development. If you are in the home, you can reach the neonatal oxygen needs by oxygen enrichment. Avoid irreversible damage to organ development and mental development due to long periods of hypoxia.
Cause
Cause
Temporary bruising
(1) Physiological cyanosis: normal newborns may present cyanosis within 5 minutes after birth, because the arterial catheter and the foramen ovale have not been closed, and still maintain a right to left shunt, the lung has not fully expanded, and the lung ventilation function is imperfect. And caused by poor blood perfusion in the surrounding skin. After 5 minutes, the changes of the circulatory system have completely separated the arteriovenous blood flow, and the lips and nail bed become pink, but sometimes the skin is still mild cyanosis, especially after exposure to cold environment, and the local blood flow at the distal end of the limb becomes slow. The reduction of hemoglobin is increased, so although PaO2 is not low in the extremities, it is obviously cyanotic, called peripheral cyanosis. After strengthening the heat preservation, cyanosis can be alleviated or disappeared.
(2) Temporary bruising: Normal newborns may appear cyanosis when crying hard, because the intrathoracic pressure increases when crying, so that the right atrial pressure rises above the left atrial pressure, forming a right to left shunt through the oval hole. This temporary bruising disappeared immediately after the cry stopped.
2. Central cyanosis: caused by cardiopulmonary disease, which reduces arterial SO2 and PaO2, and can be divided into pulmonary and cardiogenic according to the cause.
(1) pulmonary-induced bruising: such as neonatal asphyxia, congenital malformation of the respiratory tract, such as Pierre-Robin syndrome, nostril obstruction, hyaline membrane, lung insufficiency, pneumonia, qi, qi, congenital anastomosis, congenital pulmonary arteriovenous , continue fetal circulation and so on.
(2) Cardiac cyanosis: congenital heart disease with right-to-left shunt is more common in the neonatal period: tetralogy of Fallot, large vessel translocation, left ventricular dysplasia, syndrome pulmonary ectopic, Recurrent total arterial dry tricuspid atresia and severe pulmonary stenosis.
3. Peripheral cyanosis: As the blood passes through the surrounding capillaries, the blood flow rate is slow, the tissue oxygen consumption increases, and the amount of local reduced hemoglobin increases, but the arterial SO2 and PaO2 are normal.
(1) Systemic diseases: slow blood flow in systemic circulation during heart failure, decreased cardiac output during shock, decreased peripheral blood supply, and stagnant erythrocytosis in capillary blood vessels, increased blood viscosity, hard swelling, low body temperature When the blood concentration is reduced, the blood flow will slow down and the cyanosis will appear.
(2) local blood flow disorder: the first exposed part of the body during the pressure, such as the face, buttocks, etc. can appear cyanosis. In addition, cyanosis can also occur in the limbs of the newborn.
Others such as: central nervous system disorders caused by respiratory center failure, hypoglycemia, hypocalcemia caused by secondary apnea abnormalities, increased hemoglobin such as hereditary methemoglobinemia, acquired methemoglobinemia, M-hemoglobinemia, etc. Can cause cyanosis.
Examine
an examination
Related inspection
Amniotic fluid foam test amniotic fluid foam test general radiography examination arterial blood gas analysis blood test
For the examination of newborns with or without cyanosis, it is necessary to correctly distinguish between peripheral cyanosis and central cyanosis. Lips and oral mucosa are the most reliable and sensitive parts of true cyan. Significant local cyanosis is still required in neonates to be differentiated from certain skin pigmentation such as viviparous. Newborns often have a common skin pattern that is more pronounced in cold environments and is caused by autoregulation instability of skin vasomotor. Infants with a first childbirth can be seen on the head and face due to pressure caused by congestion, edema, local skin and even lips can be blue-purple, should be distinguished from central cyanosis. Newborns with cyanosis should be treated with oxygen in a timely manner. Hair blemishes suggest hypoxia in the body, which may cause damage to vital organs such as the brain, heart, kidney, lungs, etc., which may affect their mental and physical development.
Diagnosis
Differential diagnosis
Differential diagnosis of neonatal cyanosis:
Peripheral hair blemishes: Cyanosis is limited to peripheral hair strands at the lower extremities such as the extremities, the auricles, and the tip of the nose. It can be improved after warming.
Generalized cyanosis with dyspnea: systemic cyanosis with difficulty breathing should consider amniocentesis, milk or vomit intrusion, and immediately aspirate it with a straw and give oxygen. Suspected pneumonia were given antibiotics. In immature children with generalized cyanosis, suspected atelectasis and respiratory distress syndrome, should be positive pressure oxygen, and further confirm the diagnosis.
Bleeding and difficulty breathing or convulsions: Spontaneous fistula and difficulty breathing or convulsions during surgery, and intracranial hemorrhage should be considered and treated accordingly.
Generalized cyanosis and cardiac positive signs: systemic cyanosis and cardiac positive signs, should further exclude congenital heart malformations, fistula or tracheoesophageal fistula.
