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Hypoxia in the Term Newborn: Part Three—Sepsis and Hypotension, Neurologic, Metabolic and Hematologic Disorders

Rohan, Annie J. MSN, RNC, NNP/PNP; Golombek, Sergio G. MD, MPH, FAAP

MCN, American Journal of Maternal Child Nursing: July/August 2009 - Volume 34 - Issue 4 - p 224–233
doi: 10.1097/01.NMC.0000357914.95358.be
Feature article

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.

In this final article in the 3-part series, our experts help you to understand hypoxia as it relates to disorders you might see in newborns.

Annie J. Rohan is a Senior Nurse Practitioner, Stony Brook Hospital, Stony Brook, New York, and Jonas Nursing Scholar, Columbia University School of Nursing, PhD Program, New York, NY. She can be reached via e-mail at ajr73@columbia.edu

Sergio G. Golombek is an Associate Professor of Pediatrics and Clinical Public Health, New York Medical College, New York, NY, and an Attending Neonatologist, Maria Fareri Children's Hospital of Westchester Medical Center, Valhalla, New York.

The authors have disclosed that they have no financial relationships related to this article.

© 2009 Lippincott Williams & Wilkins, Inc.