Blueness In Neonate

*HOW TO DO HYPEROXIC TEST: 1. Take ABG (arterial) at room air to measure pao2(for base line) 2. Ventilate baby with 100% oxygen with hood for 15 minute. 3. Take ABG to rechek pao2 after oxygenation #Limitation of hyperoxictest 1. some cyanotic heart disease test don’t failed eg . TAPVR due to large

pulmonary blood flow. 2. In massive intrapulmonary shunt from lung disease (but with normal heart) don’t passed hyperoxitest

RIGHT TO LEFT SHUNT TEST: This test is done for persistent pulmonary hypertension. 1. By calculating difference in saturation of preductal (right hand) and postductal(left hand or lower limb) supplied area by pulse oximeter simultaneously - if difference of saturation is >10% it is significant. 2. By measuring difference of pao2(arterial) simultaneously in preductal ( Rt arterial ,rt brachial, ) and post ductal(left brachial ,left radial, lower limb especially posterior tibial) Difference=preductal pao2- post ductal pao2 Difference >15% (predutal>postductal) is significant.

** In methemoglobinemia pao2 is normal while spo2 is lowinvestigate cause for methemoglobinemia and plan to start methylene blue and vit c

Note - Hyperoxic test should not be done by pulse oximeter.