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%.