Das zyanotische Kind mit kardialer Erkrankung im Notfalldienst

Tomaske, Maren; Kadner, Alexander; Fasnacht, Margrit; Bauersfeld, Urs (2009). Das zyanotische Kind mit kardialer Erkrankung im Notfalldienst. Notfall + Rettungsmedizin, 12(1), pp. 51-55. Springer-Medizin-Verlag 10.1007/s10049-007-0966-8

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In contrast to the adult population with predominant pulmonary disease like chronic obstructive lung disease, a central cyanosis in the pediatric population is mainly caused by a congenital heart defect. The incidence of cyanotic congenital heart defects is about 13 per 10000 live births. Due to the fact, that nowadays even complex heart defects are successfully palliated, the chance to come across a child with central cyanosis in the emergency setting rises steadily. Reasons for the desaturated blood in the great arteries can either be a reduced lung perfusion or an increased mixture of arterial and venous blood due to a right-to-left shunt. The best indicator to detect a central cyanosis is the tongue since it has a rich vascular supply and is free of pigmentation. Depending on the child’s age, the essential primary rescue therapy is either the application of volume or high oxygen. In other cases no rescue therapy is required. After the preclinical rescue therapy, the child should always be admitted to a hospital, preferably to a pediatric intensive care unit or pediatric cardiology.

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