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Blue baby syndrome can refer to conditions that cause cyanosis, or blueness of the skin, in babies as a result of low oxygen levels in the blood. This term has traditionally been applied to cyanosis as a result of:. [1] Cyanotic heart disease, which is a category of congenital heart defect that results in low levels of oxygen in the blood. [2]
PPHN can range from mild to severe disease. In the most severe form, infants experience severe hypoxemia resulting in cardiac and pulmonary complications. [4] As a result of low oxygen levels, infants with PPHN are at an increased risk of developing complications, such as asphyxia, chronic lung disease, neurodevelopment issues, and death.
Tissue hypoxia refers to low levels of oxygen in the tissues of the body and the term hypoxia is a general term for low levels of oxygen. [2] Hypoxemia is usually caused by pulmonary disease whereas tissue oxygenation requires additionally adequate circulation of blood and perfusion of tissue to meet metabolic demands.
Intrauterine hypoxia can be attributed to maternal, placental, or fetal conditions. [12] Kingdom and Kaufmann classifies three categories for the origin of fetal hypoxia: 1) pre-placental (both mother and fetus are hypoxic), 2) utero-placental (mother is normal but placenta and fetus is hypoxic), 3) post-placental (only fetus is hypoxic).
Central cyanosis occurs due to decrease in arterial oxygen saturation (SaO2), and begins to show once the concentration of deoxyhemoglobin in the blood reaches a concentration of ≥ 5.0 g/dL (≥ 3.1 mmol/L or oxygen saturation of ≤ 85%). [4] This indicates a cardiopulmonary condition. [1] Causes of central cyanosis are discussed below.
An infant with severe perinatal asphyxia usually has poor color , perfusion, responsiveness, muscle tone, and respiratory effort, as reflected in a low 5 minute Apgar score. Extreme degrees of asphyxia can cause cardiac arrest and death. If resuscitation is successful, the infant is usually transferred to a neonatal intensive care unit.
Blood oxygen levels fall and carbon dioxide rises, resulting in rising blood acid levels and hypoxia. Structural immaturity, as manifested by a decreased number of gas exchange units and thicker walls, also contributes to the disease process. Therapeutic oxygen and positive-pressure ventilation, while potentially life-saving, can damage the lung.
Blood oxygen saturation may be used for hypoxic hypoxia, but is generally meaningless in other forms of hypoxia. In hypoxic hypoxia 95–100% saturation is considered normal; 91–94% is considered mild and 86–90% moderate. Anything below 86% is considered severe. [8] Cerebral hypoxia refers to oxygen levels in brain tissue, not blood.
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