Persistent pulmonary hypertension of the newborn: not a honeymoon anymore

Hypoxia in the term newborn: part three--sepsis and hypotension, neurologic, metabolic and hematologic disorders

Causes of hypoxia and cyanosis in the term newborn can be found within all physiologic systems and take the form of hundreds of specific diagnoses. In the first and second parts of this series, a wide range of cardiac and pulmonary causes for newborn hypoxia and cyanosis have been examined. Because they are familiar, cardiac and pulmonary diagnoses often represent our reactionary opinions-the options that we first entertain even before a proper systematic approach to the infant has been taken. In this final of a three part series, neurologic, hematologic and metabolic disorders are explored as a cause for abnormal oxygenation, as well as sepsis and hypotension. It is within these final categories that we find many of the obscure possibilities for neonatal hypoxia-the diagnoses that often require rigorous testing, or more sophisticated laboratory interpretation. Without consideration of these elusive entities, however, appropriate treatment and referral will be unnecessarily delayed.

Hypoxia in the term newborn: part one-cardiopulmonary physiology and assessment

In this first of a three-part series on hypoxia in the term newborn, the emphasis is on cardiopulmonary adaptation of the newborn. This article includes definitions and features of neonatal hypoxia and reviews structural abnormalities of the heart and great vessels, along with pulmonary hypertension. During the transitional phase from intrauterine to extrauterine life, newborn infants require close monitoring in order to recognize and address abnormalities in adaptation. The evaluation of the hypoxic infant is one of the most common problems for the pediatric clinician; although there are several common causes for newborn cyanosis, myriad disorders spanning all organ systems exist as possibilities etiologies. Knowledge of the breadth of feasible diagnoses and a systematic approach to the assessment of these term newborns are essential for accurate diagnosis, treatment, and referral.