Cyanosis is defined as a change in bluish or purplish color on the skin or mucous membranes because the tissue near the skin surface has low oxygen saturation. Based on the work of Lundsgaard and Van Slyke, it is classically described as occurring if 5.0 g/dL of deoxyhemoglobin or greater is present. This is based on an estimate of capillary saturation based on mean arterial and peripheral venous blood gas measurements. Since hypoxic estimates are usually now based on arterial blood gas measurements or pulse oximeters, this may be excessive, with evidence that a 2.0 g/dL deoxyhemoglobin level can produce cyanosis. Because, however, the presence of cyanosis depends on the absolute amount of deoxyhemoglobin, the bluish color is more easily seen in those with high hemoglobin counts than those with anemia. Also, the more blue color, the harder it is to detect on deep pigmented skin. When cyanosis signs appear first, such as on the lips or fingers, intervention should be done within 3-5 minutes because severe hypoxia or severe circulatory failure can cause cyanosis.
The name cyanosis literally means blue disease or blue condition . It comes from the color of cyan, which comes from ??????, kyanÃÆ'³s , the Greek word for blue .
Video Cyanosis
Definisi
Cyanosis is defined as a bluish color change, especially in the skin and mucous membranes, due to excessive deoksihemoglobin concentrations in the blood caused by deoxygenation.
Cyanosis is divided into two main types: center (around the core, lips, and tongue) and peripheral (only extremities or fingers).
Maps Cyanosis
Forms and causes
Central cyanosis
Central cyanosis is often caused by circulatory or ventilatory problems that cause poor blood oxygenation in the lungs. This develops when arterial oxygen saturation falls below 85% or 75%.
Acute cyanosis can be caused by shortness of breath or choking, and is one sure sign that breathing is inhibited.
Central cyanosis may be caused by the following causes:
1. Central nervous system (disturb normal ventilation):
- Intracranial hemorrhage
- Drug overdose (eg heroin)
- Tonic-clonic seizures (eg grand mal seizures)
2. Respiratory system:
- Pneumonia
- Bronchiolitis
- Bronchospasm (eg asthma)
- Pulmonary hypertension
- Pulmonary Embolism
- Hypoventilation
- Chronic obstructive pulmonary disease, or COPD (emphysema)
3. Cardiovascular Disease:
- Congenital heart disease (eg Tetralogy of Fallot, right to left shunt in heart or large vessels)
- Heart failure
- Valvular heart disease
- Myocardial infarction
4. Blood:
- Methemoglobinemia * Notice this causes "false" cyanosis, because, since methemoglobin is blue, patients may present cyanosis even in the presence of normal arterial oxygen levels.
- Polycythaemia Congenital cyanosis (HbM Boston) arises from a mutation in the -odon that produces a primary sequence change, H -> Y. Tyrosine stabilizes the Fe (III) (oxyhaemoglobin) formation of a permanent Hb state.
5. Others:
- High altitude, cyanosis can develop from altitude to altitude & gt; 2400 m.
- Hypothermia
- Obstructive sleep apnea
Peripheral cyanosis
Peripheral cyanosis is the blue color of the fingers or extremities, due to inadequate or inhibited circulation. Blood reaches the limb not rich in oxygen and when viewed through the skin a combination of factors can lead to the appearance of blue color. All the factors contributing to central cyanosis can also cause peripheral symptoms to appear but peripheral cyanosis can be observed in the absence of heart or lung failure. Small blood vessels can be restricted and can be treated by increasing normal blood oxygenation levels.
Peripheral cyanosis may be caused by the following causes:
- All common causes of central cyanosis
- Reduces cardiac output (eg heart failure or hypovolemia)
- Cold exposure
- Chronic obstructive pulmonary disease (COPD)
- Artery obstruction (eg peripheral vascular disease, Raynaud's phenomenon)
- Venous obstruction (eg deep vein thrombosis)
Differential cyanosis
Differential cyanosis is a lower bluish color but not the upper limb and head. This is seen in patients with patent ductus arteriosus. Patients with large ducts develop progressive pulmonary vascular disease, and excessive pressure from the right ventricle occurs. As soon as the pulmonary pressure exceeds the aortic pressure, a reversal of the shunt (right-to-left shortcut) occurs. The upper limb remains pink due to the brachiocephalic stem, leaving the common carotid stem and the left subclavian rod released proximal to the PDA.
Approach for diagnosis
- Ask about duration (cyanosis from birth shows congenital heart disease) and exposure (drugs or chemicals that cause abnormal hemoglobin).
- Distinguish the center from peripheral cyanosis.
- Check clubbing nails: The combination of clubbing and cyanosis indicates congenital heart disease and sometimes lung disease.
- If cyanosis is localized to the extremities, evaluation for peripheral vascular obstruction.
- Evaluate abnormal hemoglobin with hemoglobin electrophoresis, spectroscopy and methemoglobin level measurements.
See also
- Acrocyanosis
- Blue baby syndrome
- Raynaud's phenomenon
- Blue Fugat
References
Source of the article : Wikipedia
0 Comments