Cyanosis in the Newborn (<48 hrs) Detailed pregnancy and delivery history Detailed physical exam check SaO2 SaO2 low Cyanosis of mouth, tongue, face, core Otherwise appears well SaO2 normal Cyanosis of hands, feet, perioral Central Cyanosis Apply oxygen Chest x-ray Peripheral Cyanosis Acrocyanosis (often normal in otherwise healthy newborns) No improvement of SaO2 supplemental O2 Improvement of SaO2 with supplemental O2 Often presents with significant respiratory distress Variable response to supplemental O2 Cardiovascular Respiratory (May not necessarily be cyanotic) Other Congenital Heart Disease* Transposition of the Great Arteries Truncus Arteriosus Total Anomalous Pulmonary Venous Return Tricuspid Atresia Tetralogy of Fallot Pulmonary Atresia Ebstein’s anomaly Upper Airway Congenital upper airway obstruction (Eg. Atresia, laryngomalacia) Airway compression (Eg. Congenital neck mass, mediastinal mass) Lower Airway Pneumonia* Pneumothorax Meconium aspiration/meconium pneumonitis Congenital lung anomalies Sepsis* Hematologic (Eg. Anemia*, Hemoglobinopathies*, Polycythemia Metabolic disease * Persistent Pulmonary Hypertension Disordered control of breathing (Eg. Seizure*, birth trauma* causing intracranial injury, peripartum maternal narcotics) Indicates Key Condition This is not an exhaustive list of medical conditions

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