CYANOSIS AND CYANOSIS ON FEEDING IN TERM INFANTS

Wong HL, Ng PC, Wong Y, Gu JS, Wong W, Cheung KL, Fok TF

Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China

 

Objectives: To evaluate the clinical significance of cyanosis and cyanosis on feeding in term infants. To identify the risk factors associated with abnormal clinical outcomes

Methods: 415 patients were divided into cyanosis group and cyanosis on feeding group based on the initial presentation. The clinical course and final outcome of all the cases were evaluated. Subgroup analysis was done using severely abnormal outcome Vs normal outcome and benign abnormal outcome Vs normal outcome.

Results: Cyanosis group: The following risk factors were more prevalent in cases with abnormal outcomes: Tachypnoea, first-hour desaturation and first day-lowest SaO2.  Subgroup analysis using severely abnormal Vs normal outcome showed stronger associations in these factors. The negative predictive value was 96%.  Other factors like apnoea, grunting, insucking and presentation age did not have any significant effect on the final outcome.  No statistically significant factors were identified in benign abnormal Vs normal outcome group. Cyanosis on feeding group: Tachypnoea and first day-lowest SaO2 were also significantly associated with abnormal outcomes. The negative predictive value was 90%. The main causes for abnormal outcome in the cyanosis group were cardiovascular and pulmonary diseases whereas sepsis and pulmonary diseases were more common in the cyanosis on feeding group.

Conclusion: Tachypnoea, desaturation and lowest SaO2 are significant risk factors associated with abnormal outcomes.  When they are used to predict final outcome, the negative predictive value is > 90%.

 
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