Cyanosis refers to the bluish skin color attributable most often to the presence of desaturated hemoglobin ( 5g/dl ). Primary etiologies include respiratory, cardiac, circulatory and nervous system disorders, as well as abnormal hemoglobin.
Respiratory Diseases
1. Lung disease
Newborn: Lung hypoplasia , Diaphragmatic hernia, respiratory distress syndrome, transient tachypnea of the newborn, Bronchopulmonary dysplasia, Pulmonary interstitial emphysema, Congenital adematoid malformation, Meconium aspiration.
Infectious: Pneumonia, Pneumonitis, Bronchiolitis.
Asthma
Cystic fibrosis
Infiltrative disease: Pulmonary hemosiderosis, sarcoidosis
2. Airway abnormalities or Obstruction
Congenital: choanal atresia, macroglossia, micrognathia, laryngeal web, tracheal stenosis, vascular ring, tracheoesophageal fistula.
Infectious: Acute epiglottitis, croup, retropharyngeal abscess, laryngospasm.
Traumatic: Vocal cord injury, pneumothorax, pneumomediastinum
Others: lymphoma, cystic hygroma, goiter, laryngeal hemangioma or neoplasm, foreign body, obesity.
3. Trauma
Pneumothorax, pneumomediastinum, vocal cord injury.
Pulmonary Vascular Diseases
1. Primary pulmonary hypertension
Cyanosis requires a right to left shunt at the atrial or ductal level unless lung disease is present.
2. Pulmonary arteriovenous malformation
Idiopathic or associated with congenital heart, hepatic or portal disease.
Cardiac Diseases
1. Cyanotic congenital heart diseases
These include Transposition of great arteries, hypoplastic left heart syndrome, tetralogy of fallot, truncuc arteriosus, tricuspid atresia, total anomalous oulmonary venous connection, pulomonary atresia, ebstein anomaly of tricuspid valve.
2. Persistent pulmonary hypertension of the newborn
3. Severe congestive heart failure
As a result of congenital heart disease or acquired heart disease or infection ( myocarditis )
Circulatory Disorders
Cyanosis is the result of increased venous desaturation due to increased extraction of oxygen in peripheral tissues from diminished supply of blood to those tissues.
conditions include :
1. Shock
2.Sepsis
3. Hypogycemia
4. Cardiomyopathy
5. Vena cava obstruction
6. Hypotension
7. Peripheral Cyanosis
Neurologic Problems
1. Apnea
Prematurity, cereberal anomalies, intracranial hemorrhage, meningitis or encephalitis
2. Breath holding spells
3. Respiratory muscle weakness
Myotonic or muscular dystrophy, Gullain barre syndrome, Myasthenia gravis , infant botulism
4. Seizures
Hemoglobin Abnormalities
1. Methemoglobinemia
2.Low oxygen affinity hemoglobin
3. Polycythemia or hyperviscosity syndrome
