Treatment of cyanosis

By Dr Ananya Mandal, MD

Cyanosis or bluish discoloration of the skin and mucous membranes is a symptom of inadequate oxygenation of blood.

It is a symptom of an underlying condition rather than being a disease in itself. Treatment of cyanosis thus focuses on the underlying disease rather than the symptom alone. (1-4)

Warming of the affected areas

Peripheral cyanosis brought about by exposure to cold or Raynaud’s phenomenon and acrocyanosis may be treated symptomatically using gentle warming of the fingers and toes.

Surgery as a treatment for cyanosis

Treatment of central cyanosis due to congenital heart defects may often involve surgery.

For example, therapy of Tetralogy of Fallot (TOF) needs surgery soon after birth. If the symptoms are less severe, surgery may be performed at the age of three to six months.

Open heart surgery is usually used to treat TOF. The defects of the heart valves are corrected during the surgery.

Oxygenation as a treatment for cyanosis

Initial stabilization requires oxygenation. Sometimes a breathing machine or ventilator might be required.

First the physician checks with the airway or the wind pipe are clear before oxygenation.

If there is an obstruction or difficulty, an endotracheal tube is inserted and oxygen is administered through it.

Intravenous fluids

Children who have difficulty in feeding due to cyanosis and heart failure due to an underlying cyanotic heart disease need to be administered intravenous fluids.

Drugs as a treatment for cyanosis

In heart failure patients drugs are prescribed to reduce the excess accumulation of fluids. These are called diuretics.

Heart failure patients and those with cyanotic heart disease also need drugs that help the heart pump harder. Drugs may also be prescribed to treat abnormal heartbeats or rhythms.

Antibiotics are prescribed to prevent infections and also for treatment of pneumonia and other infections.

Immunizations for children with cyanosis

Children with congenital heart disease require regular and up to date immunizations to prevent infections. Some patients may need a permanent pacemaker.

Injections for babies with cyanosis

In babies detected with Transposition of the great arteries (TGA) as cause of cyanosis at birth, an injection of medication called prostaglandin is given shortly after birth.

The right side of the heart contains the venous deoxygenated blood whereas the left the oxygenated blood. TGA causes intermixing of the sides leading to cyanosis.

This will prevent the ductus arteriosus closing after birth. The ductus arteriosus is the passage between the aortic and pulmonary valve (the right and left side of the heart).

Keeping the ductus arteriosus open causes the intermixing of oxygenated and deoxygenated blood. Once the baby is stable a surgery is performed to correct the defect.

Babies with Tricuspid atresia also need initial prostaglandin injections and later surgery. For babies with Total anomalous pulmonary venous connection (TAPVC) surgery is recommended.

Patients with Patent ductus arteriosus can be treated with medication after birth. They may be given Indomethacin or Ibuprofen. This helps in closure of the duct. If drugs do not help, the opening may be closed using surgery.

Glucose administration

Cyanosis due to other causes like low blood sugar can be managed by glucose infusions and glucose administration. (1-4)

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Further Reading

Cyanosis - What is Cyanosis?
Causes of cyanosis
Symptoms of cyanosis
Diagnosis of cyanosis

Sources

  1. http://www.nhs.uk/Conditions/Congenital-heart-disease/Pages/Treatment.aspx
  2. http://www.umm.edu/ency/article/001104trt.htm
  3. http://www.patient.co.uk/doctor/Cyanosis.htm
  4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598396/
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