Pediatric emergency medicine trisk 2470 2470
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ED Pathway for Evaluation/Treatment of Neonates
Hyperbilirubinemia/Jaundice
URL: />Authors: D. Aronson, MD; J. Lavelle, MD; C. Jacobstein, MD; N.
Boorstein, RN
Posted: October 2009, last revised January 2018
With
ED Clinical Pathway for Evaluation/Treatment of Febrile Young
Infants (0–56 Days Old)
URL: />Authors: R. Scarfone, MD; P. Gala, MD; A. Murray, MD; M.K. Funari,
RN; J. Lavelle, MD; L. Bell, MD; C. Jacobstein, MD
Posted: August 2010, last revised August 2019
Color Changes
Cyanosis
CLINICAL PEARLS AND PITFALLS
Cyanosis may not be visible toward the end of the neonatal period
because of physiologic anemia.
Benign acrocyanosis may involve the perioral region but spares the lips
and mucous membranes.
Diarrheal illness and/or dehydration can lead to acquired
methemoglobinemia.
Current Evidence. Cyanosis refers to a blue tone visible in the skin and mucous
membranes, caused by desaturated or abnormal hemoglobin. The human eye can
detect cyanosis when there is at least 5 g/dL of reduced hemoglobin. Therefore,
hemoglobin oxygen desaturation may be missed if there is anemia. Conversely,
abnormal hemoglobin may be saturated with oxygen yet unable to release to the
tissues, resulting in visible cyanosis. Methemoglobinemia is a classic example of
this situation. Central cyanosis is caused by deoxygenated blood entering the
systemic circulation. This is usually due to CHD, specifically cardiac defects
