cyanosis is defined as the bluish color of the mucous membranes and / or skin caused by a high concentration of reduced hemoglobin in the blood.Cyanosis due to hit in various blood dyes or deposition in the skin of various substances with such properties are called false cyanosis of the skin.
true cyanosis is considered a symptom of the general and local hypoxemia.It is detected when the concentration of reduced hemoglobin in the capillary blood of more than 50 g / l (at standard to 30 g / l).It pronounced in patients with polycythemia, whereas anemia cyanosis of skin appears in the case where more than half of the hemoglobin becomes reduced.
cyanosis itself practically does not occur.It can develop as a result of acute, urgent diseases and conditions of the patient, and can be a symptom of chronic, sub-acute conditions and diseases.
In acute development of the disease is usually observed, Generalized cyanosis.When pulmonary embolism is characterized iron upper
Pulmonary edema is also characterized by cyanosis face, nasolabial triangle, the upper half of the body, accompanied by the release of a pink frothy sputum and severe distress - syndrome.
patient with cyanosis of skin suffering from a disease in the subacute form, which developed within 3-5 days, is likely to start development of pneumonia (pneumonia) or septicemia (blood poisoning).Also, generalized rash, along with cyanosis talk about toxic shock.
Patients having a chronic disease is combined with cyanosis likely to have problems in the cardiovascular and pulmonary systems.Bronchitis with emphysema there are signs of respiratory distress syndrome, respiratory symptoms and whistling labored expiration, cyanosis skin.If interstitial lung fibrosis observed diffuse wheezing and difficulty chest rise.When pulmonary arteriovenous fistulas in patients may be: systolic murmur, cyanosis of the mucous membranes, hands.
When cyanosis congenital heart disease is usually observed in the mucous membranes, nasolabial triangle, on the nails of hands and feet.In addition, the patient has respiratory dysfunction, pathological form of the thorax (the protrusion of her left half), a heart murmur, a symptom of a cat purring.Chest X-ray shows cardiomegaly, altered the silhouette of the heart.And altered ECG shows right ventricular hypertrophy.
severe emerging cyanosis (developed in a matter of seconds) can be observed during asphyxia (suffocation), pulmonary arterial thromboembolism, cardiac tamponade.Cyanosis, occurring within a few hours, can be at a severe attack of asthma that is not docked, lobar pneumonia in the lungs, in case of poisoning metgemo-lobinnoobrazovatelyami.With the gradual, sometimes long development of cyanosis can speak with confidence about the problems of the heart and lungs.
With features cyanosis can diagnose a number of diseases that can sometimes save the patient's life.Cyanosis may also be confused with the disease as karboksigemoglobinemiya that occurs after inhaling carbon monoxide.It looks red cyanosis.
In its origin, and its manifestations are distinguished: central cyanosis, or as it is also called, diffuse cyanosis and peripheral cyanosis (acrocyanosis).The diffuse cyanosis, usually associated with an increased concentration of reduced hemoglobin in arterial blood.This is observed in respiratory failure in patients with bronchopulmonary diseases, with pulmonary arterial hypertension in the pulmonary circulation;or when mixed venous and arterial blood during concomitant congenital and acquired defects of the heart walls or in estuaries between the aorta and pulmonary trunk.
diffuse cyanosis Severity varies from slightly bluish hue with the tongue and lips ashen complexion to a dark bluish-purple, sometimes brown color of all the skin of the body.It is more noticeable in the mucous membranes and on those parts of the body where there is a thin skin (lips, tongue, under the nails and on the face).
In some cases, can lead to cyanosis reduced pressure atmosphere (for example, a flight in an airplane or climbing).
cyanosis nasolabial triangle
cyanosis nasolabial triangle is also called periorbital cyanosis, cyanosis that is around the eyes.He is considered the first sign of central cyanosis, which is characteristic of diseases of the pulmonary system in which there may be a decrease in arterial oxygen saturation.
cyanosis nasolabial triangle defines a child with congenital heart disease.If such a feature first appeared, and not in the very first months of baby's life, you should immediately consult a cardiologist or pediatrician, or call an ambulance.This may indicate a heart or lung disease in a child.
diagnosis of heart disease was confirmed by ECG and echo listening heart.Cyanosis of nasolabial triangle is often a sign of cerebral ischemia.This condition requires inspection and recommendations neurologist.Final diagnosis of the baby can be delivered only by means of ultrasound.These same characteristics may indicate a cardio-pulmonary system in the adult.In this case it is necessary to carry out brain CT, MRI, EEG, REG.To exclude or confirm heart disease: consulting cardiologist, EKG, heart ultrasound, x-ray.
Since cyanosis nasolabial triangle indicates a lack of oxygen (hypoxia), we can think about the presence of anemia in a child or adult.In this case it is necessary to conduct a clinical trial of blood.Cyanosis of red color on the skin of the chin, cheekbones, brow, external genital organs can occur in women with diabetes.
cyanosis in a child
cyanosis of the child at birth and during the first days of life may be at the origin of respiratory, cardiac, metabolic, hematological and cerebral nature.Localization on the periphery of the characteristic vasomotor cyanosis, which usually can be seen in the first weeks of baby's life, much less - in the first months.Cyanosis is available on the hands, feet, and mucous membranes and lips are pink.In diffuse cyanosis blue painted lips, and mucous membranes, and skin.
The child diffuse cyanosis, which is manifested immediately or soon after birth, often due to congenital heart disease.Its intensity depends on the size of the shunt venoarterialnogo, volume of blood flowing through the lungs, and the content of hemoglobin in arterial blood.
Respiratory diffuse cyanosis can occur in the lungs atelectasis, aspiration asphyxia, hyaline membrane disease, pneumonia, and other bronchopulmonary diseases.
the first power failure, respiratory cyanosis observed in the perioral area.He is fickle, aggravated by nervous tension and endangered by inhalation of 50% oxygen.
At second degree and perioral cyanosis, but may still be on the face, on the hands.It is a constant, not endangered by inhalation of 50% oxygen, but it is not in an oxygen tent.
When the third degree of respiratory failure observed generalized cyanosis that does not pass by inhalation of 100% oxygen.Cyanosis in children with intracranial hemorrhages and edema of the brain called the cerebral cyanosis.Metabolic cyanosis may occur in tetany in newborns when the calcium content in the blood plasma of less than 2 mmol / L and there is hyperphosphatemia.
cyanosis of the skin can be placed on any part of them.Cyanosis of the extremities can cause venous congestion or arterial thromboembolism.The peripheral acrocyanosis may be particularly benign condition in which cyanosis is more pronounced in the upper extremities than in the lower.And it is associated with a different density of the capillary bed.
cyanosis of the skin, more pronounced on the hands than the feet, can testify to the transposition of large arteries to the presence of excessive coarctation.This gives rise to pulmonary hypertension reduces the emission by cleft arterial duct, which is why the extremities oxygenated blood rushes.Fingers in the form of drum sticks and cyanosis, which is more pronounced in the legs than in the left hand, at the moment as the right hand has a relatively normal color of the skin, confirmed the diagnosis of pulmonary hypertension with a return over the arterial blood flow through the open arterial, izcausing the lower limb arterial blood enters neoksigenirovannaya.
With the defeat of the pulmonary artery is the development of a black cyanosis;in diseases of the heart muscle cyanosis darker than in violation of the respiratory function;when the main vein thrombosis occurs cyanosis limbs with their swelling;while marble or mottled cyanosis of the extremities we can talk about thrombosis or embolism trunk, or symptoms of Marburg;acrocyanosis in the forearms and hands can talk about young women angioneurosis Cassirer;dark purple spots in the nose, ears, fingers develop at mikrotrombozov;Red cyanosis occurs when a person politsetemii, in tumors of internal organs;bright red facial cyanosis there for tumors of the adrenal and pituitary;cyanosis saffron skin soles and hands with hemorrhages observed in the abdominal cavity;cyanosis of the face and body with a purple tinge may be observed in acute pancreatitis;cyanosis of the face and petechial hemorrhages in the face and neck are talking about traumatic asphyxia;Spotted cyanosis of the lower extremities indicates chronic venous insufficiency;cyanosis of the feet can occur with prolonged cooling in high humidity or overcooling;cyanosis of the feet and hands can be at the first stage of Raynaud's syndrome.
Treatment cyanosis is determined primarily by the disease.Often, mainly in cases of emergency, the existence of cyanosis only an indication for oxygen therapy, thus leading to an intensification of treatment of the underlying disease.In these cases, the reduction or elimination of cyanosis can be regarded as an indicator of the effect of the treatment.When cyanosis, acute arisen, you should immediately call the ambulance brigade.
Acrocyanosis represented as a benign condition, and if the specialist puts such a diagnosis, the need for medical activities there.
Methaemoglobinemia half of the cases can be congenital, or may in the other half of cases occur because the drugs medicines.Often it causes aniline derivatives, nitrites, sulfonamides.Methemoglobinemia due to drug disappears quickly after the abolition of the drug.Receiving Methylene Blue orally at a dose of 150-200 mg per day restores function of the oxygen in arterial blood of the two kinds of methemoglobinemia, at this time of ascorbic acid at a dose of 150 to 550 mg may produce an effect only in congenital methemoglobinemia.
When a state of acute airway obstruction, which developed as a result of falling food and jams, as the method of choice of therapy may be krikotirotomiya.In the case where the obstruction of the upper respiratory tract caused by inflammation or swelling of the epiglottis, required a tracheotomy.
In therapy pulmonary embolism require therapy with streptokinase and heparin.As a rule, pulmonary embolism, which is accompanied by cyanosis, an urgent need of mechanical ventilation and oxygen therapy.
When pneumonia and sepsis, which lead to the appearance of cyanosis, may be shown: mechanical ventilation, oxygen and receiving broad-spectrum antibiotics.
When pneumothorax, which leads to cyanosis, can be carried out drainage of the pleural cavity and ventilation.
Treatment of pulmonary edema depends on the cause of the disease.Cardiogenic pulmonary edema is usually determined excessive increase pulmonary capillary pressure and cured with diuretics and drugs that reduce subsequent load on the heart.Not cardiogenic pulmonary edema is often associated with the violation of the permeability of the capillaries in the alveoli, pulmonary capillary pressure at all this can remain normal.The main method of treatment in this group of patients is considered to be ventilation.
Therapy emphysema and bronchitis is the use of bronchodilator drugs, with mechanical ventilation and to treat concomitant bacterial infection.Exceptional patients with allergic airway injuries appointed corticosteroids.
therapy in congenital heart defects is to determine the exact diagnosis, controlling pulmonary infections, if any, in the prevention of endocarditis, infectious nature and in the treatment of polycythemia.Very dangerous is polycythemia in male adolescents during their puberty;hematocrit in excess of 70% are generally poorly tolerated and to reduce symptoms and reduce the risk of thromboembolic complications requiring an eritrofereza.Moreover, there may be complications such as migrenopodobnye headaches, thrombosis, hypertension and gout.