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Cyanosis: forms, causes, signs, symptoms and treatment

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Many people have repeatedly faced with such a disease as cyanosis. What is it, what is the etiology of the disease, its characteristic symptoms and effective treatments? Cyanosis is a disease in which mucous membranes and skin become bluish. Cyanosis of the skin occurs as a result of an increase in the blood concentration of the pathological hemoglobin (at a rate of up to 30 g / l, more than 50 g / l is diagnosed).

Causes of central cyanosis

The cause of central cyanosis is a small amount of oxygen entering the blood. If the heart is functioning properly, then it pumps blood into the lungs, which there becomes a rich red color and is enriched with oxygen. If the cardiovascular system malfunctions, the blood, not having received the required amount of oxygen, is unable to deliver it in sufficient volume to the cells of the whole organism. As a result, hypoxia develops, or, in other words, lack of oxygen, one of the main manifestations of which is cyanosis of the skin. The emergence of central cyanosis may be associated with heart disease, respiratory diseases, intoxication, due to which the formation of methemoglobin occurs.

Causes of Peripheral Cyanosis

Peripheral cyanosis, which is blue in the limbs or on the skin of the face, develops as a result of circulatory disorders. The blood flow in the capillaries slows down significantly, as a result of which the tissues receive more oxygen than they need, and the blood is saturated with carbon dioxide.Often this disease occurs due to thrombophlebitis of the extremities, less often due to hypothermia. Diseases of the respiratory system can also cause illness. Thus, cyanosis is diagnosed in poor gas exchange, as well as in patients with acute bronchiolitis and bronchial asthma, leading to impaired bronchial patency. Under the influence of all these illnesses, thrombosis occurs in the pulmonary artery system, leading to impaired blood circulation.

Causes of cyanosis in children

  1. Central cyanosis in children, occurring soon after birth, is usually associated with congenital heart defects.
  2. Respiratory central cyanosis is noted in stenotic croup, aspiration asphyxia, hyaline membrane disease, pneumonia, lung atelectasis, and other bronchopulmonary diseases.
  3. Cyanosis observed in children with intracranial hemorrhage and swelling of the brain, called cerebral.
  4. The occurrence of metabolic cyanosis is associated with methemoglobinemia and is diagnosed in tetany of newborns (in the blood serum, calcium content is less than 2 mmol / l) and hyperphosphatemia.

Symptomatology

The severity of central cyanosis may be different. The disease can manifest itself from a slightly cyanotic shade of the tongue and lips with an ash-gray tint of the skin to a blue-violet, blue-red or blue-black complexion of the skin of the whole body. Central cyanosis is most clearly visible on areas of the body with thin skin (lips, face, tongue), as well as on mucous membranes. The first signs of central cyanosis are periorbital cyanosis and cyanosis of the nasolabial triangle.Peripheral cyanosis is manifested by a bluish tinge of parts of the body, usually the most distant from the heart. The disease is well expressed on the hands, feet, ears, nose and lips.

Depending on the cause of the underlying disease, cyanosis can be accompanied by various symptoms: severe coughing, breath holding, rapid pulse and heartbeat, weakness, fever, blue nails.

Diagnostics

Cyanosis - what kind of disease and how it manifests itself, we found out. However, it is necessary to judge the presence of the disease only after the prospective patient has completed the full course of examination.

When diagnosing cyanosis should pay attention to:

  • taking drugs that lead to the formation of pathological hemoglobin derivatives,
  • time of onset of symptoms
  • signs of peripheral and central and cyanosis.

The analysis of arterial blood gases is intended to determine the oxygen concentration in the blood. Studies of blood flow, heart and lung functions, as well as X-rays will determine the cause of the reduced oxygen content in the blood and the resulting cyanosis.

If you suspect cyanosis of the lips, which has arisen in a newborn, to diagnose the disease, you must visit a pediatric neurologist, cardiorheumatologist, and also do an ultrasound of the thymus and heart.

Features of treatment

With the diagnosis of cyanosis that this disease requires treatment, there is no doubt in patients. The treatment should be based on the treatment of the underlying disease. Thus, the severity of the bluish skin tone will decrease as the effectiveness of the designated activities.

Cyanosis is directly treated with an oxygen mask or tent, which promotes oxygenation of the blood. The more effective this method is, the more rapidly the blue of the skin will decrease. The attending physician will prescribe drugs whose action is aimed at alleviating the cause of cyanosis and the elimination of the disease.Cyanosis - what is the skin condition and what it may indicate, everyone should know. Taking into account the seriousness of the reasons that gave rise to the skin condition under consideration, it is better not to delay the treatment of a specialist for the purpose of treatment.

Causes

Cyanosis itself is almost never seen. It may develop as a result of acute, urgent conditions and diseases, or it may be a symptom of chronic, subacute conditions and diseases.

Cyanotic coloration of the skin or mucous membranes is manifested due to an excessive amount of carbon dioxide in arterial blood. The reason for this may be a violation of gas exchange in the lungs or a mixture of arterial and venous blood. Cyanosis, which develops in a few seconds or minutes, is characteristic of pulmonary embolism and asphyxia. Cyanosis, which develops in the period from a few tens of minutes to a day, occurs with pneumonia, bronchial asthma, and chronic lung and heart diseases.

Long stay at high altitude can also lead to the appearance of cyanosis. This condition is a protective reaction of the body, is not dangerous to health and does not require special treatment.

Symptoms of cyanosis

For heart disease is characterized by the appearance of bluish color of the skin on the fingers and toes, on the nose, on the lips, ears. Diseases of the lungs, which reduce blood oxygen saturation, may be accompanied by cyanosis of the nasolabial triangle, and blue skin around the eyes.

If cyanosis developed due to hypothermia, fingers and toes turn blue.

Classification

Allocate central and peripheral cyanosis.

Central cyanosis affects both the skin and mucous membranes and is caused by a general decrease in SaO2 or the presence in the blood of pathological hemoglobin derivatives.

Peripheral is caused by slowing blood flow and is observed with hypothermia, heart failure, peripheral vascular diseases, shock. The color of the oral mucosa or the frenulum of the tongue may be normal.

Cyanosis treatment

Treatment of cyanosis is determined by the underlying disease. Cyanosis itself is treated with an oxygen mask or a tent. This allows you to saturate the blood with oxygen and restore normal hemoglobin levels, so the cyanosis recedes. The criterion for the effectiveness of this oxygen therapy is the reduction or complete disappearance of blue in the face. In a chronic disease, oxygen treatment does not eliminate the re-cyanosis.

A patient with congenital heart disease may have persistent cyanosis, which disappears only after surgery.

Cyanosis - the main symptoms:

  • Cyanosis of the skin
  • Limbs blueness
  • Blue nasolabial triangle
  • Cyanosis of nails
  • Mucosal cyanosis
  • Blue phalanges
  • Blue ears
  • Blue soles

Cyanosis of the skin and mucous membranes is the occurrence of an unnatural bluish tint on certain areas of the body and mucous membranes, which can occur in both a child and an adult. According to medical research, this pathological condition is caused by the fact that there is an increased amount of abnormal hemoglobin in the blood, which makes its color look like blue. At the same time, there is an insufficient saturation of blood with oxygen, as a result of which, to certain parts of the body, the blood is not supplied in the required volume, which causes cyanosis of the skin and mucous membranes.

In some cases, this pathological condition is extremely severe, as is accompanied by suffocation. And if a patient in such a condition does not receive medical assistance in time, the risk of his death is high.

Varieties and causes

The most common occurrence is acrocyanosis, which is characterized by a change in the color of the skin on the distal parts of the body, that is, the extremities, face. Acrocyanosis predominantly develops in patients with cardiac pathology and may be evidence of the development of a child or adult heart failure. In adults, acrocyanosis is also a sign of atherosclerosis, vascular dystonia, varicose veins and some other pathologies. But pathology is also found in infants who do not have abnormalities in the development of the cardiovascular system.

Cyanosis is localized in this type of pathology on the hands and feet, on the ears, the tip of the nose and lips. For infants during the first days of life, acrocyanosis is a normal phenomenon, since its lungs have not yet become fully functional, which is manifested by an insufficient supply of blood with oxygen. Acrocyanosis is more pronounced when the baby cries, makes excessive efforts during feeding, or shows anxiety.

It is important to understand that there are different varieties of this pathological condition. So, in medical practice they talk about central and local cyanosis. Central cyanosis develops in cases where the arterial blood is not sufficiently saturated with oxygen, which happens in severe diseases such as respiratory failure, erythrocytosis, heart defects, and others. This condition may indicate the need for urgent medical care to the person. This variety is also called diffuse cyanosis, and it has the maximum severity.

In local cyanosis, impaired blood circulation is observed in the localized area due to a local blood circulation disorder. This form of pathology is observed in places of increased accumulation of blood vessels - around the mouth, around the eyes.

The local form is also called peripheral cyanosis. The following pathological conditions can be the causes of this form of the disease:

  • slowing blood flow in the capillaries due to thrombophlebitis or squeezing them with a tumor,
  • poisoning and intoxication of the body,
  • diseases of the heart and blood vessels
  • tuberculosis and pneumonia, which prevent sufficient oxygen from entering the blood,
  • breast deformity as a result of traumatic injury with impaired respiratory function.

Cyanosis of the nasolabial triangle is often diagnosed in infants, which indicates the developmental defects of the lungs, heart and neuralgia.

In general, peripheral cyanosis is more common in medical practice than central, since there are much more causes causing it.

If a patient has such a form of pathology as acrocyanosis, which occurs predominantly in infants, its symptoms will be blue in the nails, phalanges of the fingers and soles of the child, ears and nasolabial triangle, including mucous membranes. The blueness of the mucous membranes, nails and skin can be mild or severe - and the more pronounced it is, the more severe the child’s condition, indicating acute respiratory failure.

Very often, cyanosis of the nasolabial triangle, as well as peripheral cyanosis, occurs in people with pathological conditions such as:

Symptoms of the pathological condition, manifested by cyanosis of the skin, nails and mucous membranes, differ depending on the type of disorder that caused acrocyanosis. Thus, in diseases of the lungs or bronchi, cyanosis of the lips, nasolabial triangle and mucous membranes is manifested by a dark purple color of this area, indicating a lack of oxygen.

Acrocyanosis also occurs in diseases of the heart, but the clinical picture is complemented by other symptoms, such as:

  • thickening of the phalanges of the fingers like drum sticks,
  • wet rales,
  • hemoptysis,
  • dyspnea.

Cyanosis of the extremities occurs in the peripheral form of the pathology, and is diagnosed quite often in both adults and children. At the same time, cyanosis in newborns, as mentioned above, can be both pathological and physiological in nature, therefore, medical care for infants is required only when cyanosis is strongly pronounced and does not disappear for a long time.

Types and causes of the disease

Cyanosis develops with an increased concentration of carbon dioxide in the blood. This is due to a violation of gas exchange in the lungs: carbon dioxide stops replacing oxygen from the blood. Also the culprit may be mixing arterial and venous blood. Acute cyanosis can develop in a couple of minutes with pulmonary artery asphyxiation or thromboembolism.

Up to a day will be required for the occurrence of subacute cyanosis in case of bronchial asthma or pneumonia in a severe form.

Gradually, cyanosis manifests itself during chronic lung and heart diseases. It accompanies respiratory and heart failure, and is sometimes considered a symptom of congenital heart disease. Cyanosis often accompanies many chronic lung diseases: the lung tissue is thickened, gas exchange is disturbed. Changes in blood circulation causes a mild form of cyanosis: the blood has an elevated level of hemoglobin, which slows down the movement of blood and mixes with carbon dioxide. All this leads to an increase in red blood cells and the subsequent thickening of blood, which affects the color of the lips and face, which turn blue. This type of cyanosis can have a number of hidden complications.

But the culprits of cyanosis can be not only various diseases in the human body. External factors also influence. An example would be the cold season.

Newborns suffer from cyanosis due to the underdevelopment of the respiratory system.

Long stay at a considerable height activates the protective functions of the body. The number of red blood cells begins to increase. This is called polyglobulia and is hazardous to health.

Tsinosis may be a precursor of such diseases as plague, shock, cholera, angioedema, pneumonia, diphtheria, asthma, thrombophlebitis, epilepsy.

Cardiac (peripheral) and pulmonary (central) cyanosis are distinguished. Cardiac appears with the slow movement of blood through the capillaries. Tissues begin to receive a lot of oxygen, and blood is saturated with carbon dioxide. Often occurs in heart failure with a slow outflow of venous blood. Only the doctor will prescribe the correct examination and establish the diagnosis.

In the absence of complete saturation of arterial blood, pulmonary cyanosis develops. The limit is 80 percent or less. If a person has a dark skin color, then cyanosis can only be noticed at 75%. It develops with heart defects when mixing venous and arterial blood, accompanied by respiratory failure.

Manifestations of cyanosis

Cyanosis itself does not affect the general state of health, but its causes always need to be eliminated and are a reason for going to a doctor. In some cases, the occurrence of cyanosis indicates the development of critical conditions and the need to provide the patient with emergency care. In this condition, cyanosis appears suddenly, clearly expressed and rapidly growing.

Depending on the cause, cyanosis is accompanied by various symptoms: fever, cough, shortness of breath, tachycardia, pain, intoxication and other signs. It is for him that the doctor can diagnose and determine the tactics of further treatment.

Cyanosis itself does not need therapy. It is eliminated after the start of treatment of the underlying disease and oxygen therapy. Subsequently, a decrease in its manifestations will indicate the effectiveness of the measures taken.

Oxygen therapy

Additional supply of oxygen into the patient's body allows you to saturate the blood with oxygen and reduces the blueness of the skin. However, this method of treatment is effective only in acute cyanosis. In the chronic presence of cyanosis (for example, heart disease or anemia), the removal of tissue hypoxia in this way will be a temporary measure, and for the treatment of the underlying disease, the patient must undergo a course of conservative or surgical treatment.

Кислородотерапия может осуществляться при помощи:

  • кислородной маски (простой, нереверсивной или Вентури),
  • носовых катетеров,
  • кислородной палатки,
  • аппарата искусственной вентиляции легких,
  • barotherapy

The method of supplying the oxygen mixture to the body is determined individually and depends on the clinical case. Oxygen therapy can be performed both in a hospital and at home (with the help of portable oxygen cylinders or concentrators).

For health purposes, the patient may be recommended such methods of oxygen therapy as oxygen cocktails or baths.

Drug therapy

To eliminate cyanosis and oxygen starvation of tissues, patients can be given medications that normalize blood flow, enhance erythropoiesis, heart and lung activity, or improve blood flow. The purpose of such drug therapy is to improve the supply of oxygen and its delivery to hypoxia-suffering tissues.

To reduce the manifestations of cyanosis can be prescribed:

  • respiratory analeptics - Tsititon, Etimizol, etc.,
  • bronchodilators - Berodual, Salmbutamol and others,
  • cardiac glycosides - Korglikon, Strofantin,
  • neuroprotectors - Piracetam, Nootropil, Fezam, etc.,
  • anticoagulants - Fragmin, Warfarin and others,
  • vitamin preparations.

If cyanosis is caused by a chronic disease, then after the treatment, the patient is recommended follow-up. Such continuous monitoring of the course of the disease allows time to adjust therapy and prevent the development of more severe cases of tissue hypoxia.

Cyanosis of the skin and mucous membranes is a symptom of many diseases, but more often it is detected when there are pathologies of the respiratory organs, heart or blood vessels. His appearance should always be a reason for going to the doctor. To eliminate the causes of its occurrence, the patient should undergo a comprehensive diagnosis, the data of which will allow the doctor to draw up the most productive treatment plan. In some cases, with a sudden appearance and a rapid increase in cyanosis, cyanosis indicates the development of a critical state and requires the provision of emergency assistance and call the ambulance brigade.

Oxygen therapy

Oxygen therapy can reduce the blue of the skin. Oxygenation of the blood is achieved by using an oxygen mask or a tent.

The complex treatment of respiratory and heart failure accompanied by hypoxia necessarily includes oxygen therapy. Inhalation of oxygen through the mask helps to improve the general condition and well-being of patients. Cyanotic seizures that occur when performing physical work or against a background of fever disappear after a brief inhalation of oxygen.

A closed oxygen tent is the most appropriate method of oxygen therapy, which allows to regulate the gas mixture and the pressure of the introduced oxygen. Also, oxygen can be introduced through an oxygen cylinder, mask, pillow or probe. Centralized oxygen supply is carried out with the use of artificial ventilation.

Oxygen cocktail eliminates cyanosis and other effects of hypoxia. It improves the quality of life for many patients, restores strength, saturates the cells with oxygen, improves metabolism, attention and reaction rate. Oxygen cocktail is a thick foam filled with oxygen molecules. With the help of a special oxygen canister, juices, fruit drinks and syrups enrich with oxygen not only in conditions of medical institutions, but also at home.

Currently, oxygen concentrates produced in Europe, America and Asia are very popular. They are highly reliable, stable in operation, almost silent, have a long service life. Portable oxygen concentrates deserve special attention, providing patients with the comfort of movement and the maintenance of a mobile lifestyle.

Drug treatment

Drug therapy is aimed at improving the flow of oxygen into the body and its delivery to the tissues. To do this, patients are prescribed drugs that enhance pulmonary and cardiac activity, normalize blood flow through the vessels, improve the rheological properties of blood, enhance erythropoiesis.

To reduce the cyanosis of the skin, patients are prescribed:

  • Bronchodilators - “Salbutamol”, “Clenbuterol”, “Berodual”,
  • Antihypoxants - Actovegin, Preductal, Trimetazidine,
  • Respiratory analeptics - "Etimizol", "Tsititon",
  • Cardiac glycosides - "Strofantin", "Korglikon",
  • Anticoagulants - "Warfarin", "Fragmin",
  • Neuroprotectors - Piracetam, Fezam, Cerebrolysin,
  • Vitamins.

If the cause of cyanosis is heart disease, it is often possible to get rid of it only with the help of surgery.

Oxygen cocktails are also used to prevent hypoxia in people at risk and with chronic heart and lung diseases. In order to improve the quality of life and prevent the onset of old age, it is necessary to follow basic rules and recommendations: treat chronic diseases in time, maintain a healthy lifestyle, walk a lot in the fresh air, maintain your health and love yourself.

Additional symptoms

Cyanosis can be accompanied by such signs:

  • rapid breathing, coughing, frothy sputum, wheezing, difficulty breathing in or out,
  • change in the shape of the chest (heart hump), nails (watch glasses), fingers (drum sticks),
  • heartbeat
  • dizziness,
  • swelling of the lower limbs, cooling, trophic disorders, decreased sensitivity,
  • fever, chills, sweating, general weakness.

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