Assessment of cyanosis in the newborn Skip to main contentSkip to searchAbout usHelpSubscribeAccess through your institutionLog inBMJ Best PracticeSearchSearchSelect languageAssessment of cyanosis in the newborn MENULog in or subscribe to access all of BMJ Best PracticeLast reviewed:23 Jul 2023Last updated:22 Aug 2023SummaryCyanosis and tachypnoea are frequently encountered in the neonatal period. The prevalence of respiratory distress in newborns ranges from 2.9% to 7.6%. Cyanosis can result from a range of disorders, including cardiac, metabolic, neurological, and pulmonary disorders. In all, 4.3% of newborns may require supplemental oxygen therapy because of cyanosis.[1][2][3] Cyanosis is dependent on the absolute concentration of the reduced haemoglobin and not on the ratio
Understanding stakeholder perspectives on Apgar score, cyanosis and identifying jaundice in ethnic minority neonates. To explore neonatal assessments that include an element of evaluating skin colour in neonates of black, Asian and minority ethnicities, focusing on the Apgar score, presence of cyanosis and presence of jaundice. We employed focused ethnography involving diverse healthcare descriptor for ethnic minority neonates created a divide among both parents and HCPs. HCPs relied more heavily on other elements of the Apgar score or infant breathing and crying at birth to gauge infant wellness. When identifying cyanosis, HCPs depend on specific body locations for accurate assessment of oxygenation, but the limitations of visual assessment are acknowledged. For jaundice, most HCPs
A review of the current policies and guidance regarding Apgar scoring and the detection of jaundice and cyanosis concerning Black, Asian and ethnic minority neonates. Ethnic inequalities in maternal and neonatal health in the UK are well documented. Concerns exist regarding the use of skin colour in neonatal assessments. Healthcare professionals should be trained to recognise symptoms of diverse
Nucleated Red Blood Cell Counts Differentiate Cardiac from Respiratory Causes of Cyanosis at Birth. Tissue hypoxia increases erythropoietin production and release of immature erythrocytes that can be measured using nucleated red blood cell counts (nRBC). We hypothesized that hypoxia due to congenital heart disease (CHD) is chronic and is better tolerated than hypoxia due to respiratory disease (RD), which is an acute stress in newborns leading to higher nRBC. This study assesses the utility of nRBC as a marker to differentiate hypoxia due to CHD vs RD in term neonates. This was a single-center, retrospective study of term neonates with cyanosis from 2015 to 2022. Neonates < 37 weeks of gestation, with hypoxic-ischemic encephalopathy, and those with other causes of cyanosis were excluded
Diagnostic value of reversed differential cyanosis in (supra)cardiac total anomalous pulmonary venous return. To investigate the occurrence of reversed differential cyanosis (RDC) in case of (supra)cardiac total anomalous pulmonary venous return (TAPVR), we explored the hemodynamic changes and oxygen saturation levels during the fetal-to-neonatal transition in (supra)cardiac TAPVR, thereby value of reversed differential cyanosis in early screenings within the first 24 h after birth. By including RDC as an immediate fail in early pulse-oximetry screenings, the likelihood of missing (supra)cardiac TAPVR cases could be reduced.
A 36-Year-Old Woman With Intermittent Cyanosis. A 36-year-old woman with a medical history of opioid use disorder and frequent urinary tract infections presented to the ED from her opioid use disorder clinic, where she was found to have an oxygen saturation by pulse oximetry (Spo) of 82% on room air. Starting 3 days before presentation, the patient's family noted worsening pale complexion and blue lips at rest. These findings of cyanosis had occurred a few times before and always resolved within a couple days without any medical intervention. She had no pulmonary symptoms outside of long-standing dyspnea with moderate exertion when at work or doing chores around the house. Her medications included methadone 160 mg daily, acetaminophen 650 mg nightly as needed, and phenazopyridine 199 mg
Iatrogenic Post-Surgical Cyanosis Due to Vena Caval Redirection to the Left Atrium and Its Transcatheter Management. During surgery for oval fossa defects, inadvertent suturing of pericardial patches to a prominent Eustachian valve diverts the inferior vena caval blood to the left atrium causing iatrogenic cyanosis. A similar complication may arise after surgery for superior sinus venosus defects
Comparison of thromboelastographic profiles in pediatric patients with congenital heart disease according to existence of cyanosis. Congenital heart disease (CHD) is divided into two groups according to cyanosis status. Cyanotic CHD has a low level of systemic oxygenation and is accompanied by increased erythropoiesis. We hypothesized that pediatric patients with CHD would exhibit different thromboelastographic profiles according to their cyanosis status. The study recruited 70 pediatric patients younger than 12 months who were undergoing surgery for CHD. Patients were allocated to the acyanotic group or cyanotic group after preoperative evaluations of their diagnosis and peripheral oxygen saturation in the operating room on room air. After inducing anesthesia, blood samples were collected. Hematologic
A 77-Year-Old Woman With Capillary Hypoxia and Perioral Cyanosis. A 77-year-old woman with asthma, hypothyroidism, irritable bowel syndrome, overactive bladder, and multiple rheumatologic conditions was sent from the clinic to the ED for evaluation of hypoxia. In the clinic, she reported dizziness without shortness of breath and was noted to have perioral cyanosis with an oxygen saturation
CRACKCast E014 – Cyanosis CRACKCast E014 - Cyanosis - CanadiEM * CanadiEM MVP Infographic Series Alvin Chin Featured, Infographics August 7, 2019 * HiQuiPs (Quality Improvement) Ahmed Taher Education & Quality Improvement, HiQuiPs July 10, 2018 * CRACKCast Adam Thomas CRACKCast, Podcast August 11, 2016 * The ‘Top Five Changes’ Project: 2015 AHA guidelines on CPR + ECC update infographic Gallery * Submissions * General Submissions * Arts PRN Project * SearchCRACKCast E014 – CyanosisIn CRACKCast, Podcast by Adam ThomasNovember 17, 20161 CommentThis episode of CRACKCast covers Rosen’s Chapter 014, Cyanosis. Here are some tips for the next time someone comes in to the Emergency Department looking a little blue.Shownotes – PDF LinkRosen’s in Perspective: Key
COVID-19-associated apnea and circumoral cyanosis in a 3-week-old. Data regarding coronavirus disease 2019 (COVID-19) cases and outcomes in infants are sparse compared to older pediatric and adult populations. We present a three-week-old full-term male with a history of mild hypoxic ischemic encephalopathy (HIE) who was admitted as an inpatient twice for episodes of apnea and perioral cyanosis . The patient tested positive for COVID-19 and negative for other common respiratory viruses at both admissions. To our knowledge, this is the first report of apnea and perioral cyanosis associated with COVID-19 in an infant. This case highlights a previously undocumented COVID-19 presentation and suggests that even mildly symptomatic infants warrant viral diagnostic testing in an effort to prevent further
Cyanosis We value your privacyWe and our partners store and/or access information on a device, such as cookies and process personal data, such as unique identifiers and standard information sent by a device for personalised ads and content, ad and content measurement, and audience insights, as well as to develop and improve products. With your permission we and our partners may use precise by an increase in the deoxygenated haemoglobin level to above 5 g/dL. Patients with anaemia do not develop cyanosis until the oxygen saturation (SaO2) has fallen to lower levels than for patients with normal haemoglobin levels and patients with polycythaemia develop cyanosis at higher oxygen saturation levels. Cyanosis can be divided into either central or peripheral[1].Central cyanosisCentral cyanosis
Exon sequencing of the alpha-2-globin gene for the differential diagnosis of central cyanosis in newborns: a case report. Cyanosis is usually associated with serious conditions requiring urgent treatment in the neonatal intensive care unit (NICU). Hemoglobin M (Hb M) disease is one type of congenital methemoglobinemia characterized by cyanosis. Among these variants, α-globin chain mutations such as Hb M Boston present cyanosis from birth while other variants usually manifest later in life. We report a case of a male newborn with cyanosis apparent since birth. Surprisingly, his respiratory and hemodynamic status including normal arterial blood oxygen saturation was stable, but oxygen saturation on pulse oximetry did not increase after 100% supplemental oxygen was started. In addition
A Novel Brain Injury Biomarker Correlates with Cyanosis in Infants with Congenital Heart Disease. Cyanotic heart lesions are a complex subset of congenital heart disease (CHD) in which patients are desaturated until surgical repair or palliation. We hypothesized that a direct relationship would exist between degree of desaturation and presence of systemic inflammation and brain injury
Anomalous Connection of the Right Superior Vena Cava to the Left Atrium in a Child with Bilateral Superior Vena Cavae: An Unusual Cause of Cyanosis. Anomalous drainage of the right superior vena cava into the left atrium (LA) has been previously reported in the medical literature. We present a unique case of a child who had two superior vena cavae, a left superior vena cava that drained normally
Carcinoid heart disease revealed by cyanosis with both right and left valvular involvement: a case report Carcinoid heart disease is a frequent complication of carcinoid syndrome. It is related to the release by the carcinoid tumor and/or its metastases of bioactive substances such as serotonin. It is characterized by right-sided valvular involvement and can lead to right-sided heart failure