Symptom >> Internal Medicine >> Respiratory Medicine

Bluish-purple oral mucosa

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Hair blemishes are skin, mucous membranes (such as eyelids, oral mucosa) that appear cyan or dark red. Acute respiratory failure means that the patient's original respiratory function is normal. Due to some sudden causes, such as airway obstruction, drowning, drug poisoning, and central nervous system disorders, the body often has no time to compensate. If it is not diagnosed in time and effective control is taken as soon as possible. Measures can often be life-threatening. Difficulty breathing, earlobe, lips, oral mucosa, nails appear blue-purple, increased heart rate, elevated blood pressure, etc.

Cause

Cause

Difficulty breathing

The patient feels that the air is insufficient and the objective performance is respiratory exertion, accompanied by changes in respiratory frequency, depth and rhythm. Sometimes the nose flaps and the breathing is seen. Upper respiratory tract disorders often manifest as inspiratory dyspnea and may have three concave signs. Expiratory dyspnea is more common in incomplete obstruction of the lower respiratory tract such as bronchial asthma. Thoracic disorders, severe pneumonia, etc. manifest as mixed dyspnea. Central respiratory failure is often characterized by irregular breathing rhythms, such as tidal breathing. In the case of respiratory muscle fatigue, the performance is shallow breathing, abdominal abnormal breathing, such as inhalation, abdominal wall invagination. Respiratory failure does not necessarily have difficulty breathing, such as sedative poisoning, which can indicate a slow breathing, a lack of expression or lethargy.

Hairpin

It is a typical sign of hypoxia. As the arterial blood reduces hemoglobin, it causes the earlobe, lips, oral mucosa and nails to appear blue-purple.

The transport of oxygen in the blood is mainly achieved by binding to hemoglobin (Hb) to form oxyhemoglobin (HbO2). Hemoglobin that is not bound by oxygen is called deoxyhemoglobin, also called reduced hemoglobin. Oxyhemoglobin is bright red and deoxyhemoglobin is purple-blue. When the content of deoxygenated hemoglobin per 100 ml of blood in the superficial capillaries of the body surface is greater than or equal to 5 g, the skin and mucous membrane are light blue.

There are two determinants of deoxygenated hemoglobin in the capillaries, namely oxygen saturation and hemoglobin content. The maximum amount of oxygen that hemoglobin can bind per 100 ml of blood is called blood oxygen capacity; and the amount of oxygen actually bound by hemoglobin is called blood oxygen content. The percentage of blood oxygen content and blood oxygen capacity is blood oxygen saturation. Healthy children's arterial oxygen saturation should be greater than or equal to 95%, even if it is caused by poor crying, it should not be lower than 91%. If the arterial oxygen saturation drops to 75%, the deoxygenated hemoglobin in the capillaries increases to 5.25 grams per 100 ml of blood, and cyanosis occurs clinically. In fact, when the arterial oxygen saturation drops to 85% to 90%, experienced clinicians can already judge the embarrassment.

3. Neuropsychiatric symptoms

The neuropsychiatric symptoms of acute respiratory failure are more common than chronic ones, and may be irritability, flapping tremors, convulsions, convulsions, and coma.

4. Circulatory system symptoms

Hypoxia and CO2 retention can lead to increased heart rate and elevated blood pressure. Severe hypoxia can lead to various types of arrhythmias, even cardiac arrest. CO2 retention can cause superficial capillary and venous dilatation, manifested as hyperhidrosis, conjunctival edema, and jugular vein filling.

5. Dysfunction of other organs

Severe hypoxia and CO2 retention can lead to liver and kidney dysfunction. Clinical manifestations of jaundice, abnormal liver function; blood urea nitrogen, creatinine increased, protein and cast in the urine; upper gastrointestinal bleeding may also occur.

6. Acid-base imbalance and water and electrolyte imbalance

Respiratory alkalosis can occur due to hypoxia and hyperventilation. CO2 retention is manifested as respiratory acidosis. Severe hypoxia is associated with metabolic acidosis and electrolyte imbalance.

Examine

an examination

Related inspection

Oral endoscopic oral X-ray examination

It is usually diagnosed based on medical history, physical examination, chest X-ray and arterial blood gas analysis.

Laboratory examination: blood gas analysis: PaO26.67 kPa (type II).

Other ancillary examinations: X-ray: no abnormalities in the early stages or increased lung texture.

Bun is a cardiac abnormality in one of the important clinical manifestations of congenital heart disease, which causes the systemic venous blood to mix with the arterial blood citrus. Some venous blood does not pass through the lung for oxygenation, that is, through the abnormal pathway to divert the circulation arteries of the human body. When it exceeds 1/3 of the cardiac output, it can cause hair loss. This condition can be seen in cyanotic congenital heart disease, such as tetralogy of Fallot, complete transposition of the great arteries.

In children with non-cyanotic congenital heart disease such as ventricular septal defect or atrial septal defect, due to high left ventricular pressure, arterial blood passing through the lungs is diverted from the left ventricle to the right ventricle, which causes left to right shunt. The blood flowing into the right ventricle is again oxygenated through the pulmonary circulation, causing an increase in blood circulation in the pulmonary circulation, and the child is prone to respiratory infection without obvious cyanosis.

Diagnosis

Differential diagnosis

Acute respiratory failure refers to the normal respiratory function of the original lung, due to a variety of sudden factors, such as encephalitis, brain trauma, electric shock, drug anesthesia or poisoning, directly or indirectly inhibit the respiratory center, or neuro-muscular disorders, such as polio, Acute polyneuritis, myasthenia gravis, etc., can affect the lack of ventilation, resulting in respiratory arrest, acute respiratory failure resulting in hypoxia and carbon dioxide retention. How to identify acute respiratory failure and chronic respiratory failure.

Acute respiratory failure: refers to the normal respiratory function, due to various sudden causes, causing ventilation, or severe damage to ventilation function, sudden clinical manifestations of respiratory failure, such as cerebrovascular accident, drug poisoning, inhibition of respiratory center, respiratory muscle paralysis , pulmonary infarction, ards, etc., because the body can not be quickly compensated, if not rescued in time, it will endanger the patient's life.

Chronic respiratory failure: more common in chronic respiratory diseases, such as chronic obstructive pulmonary disease, severe tuberculosis, etc., the respiratory function damage is gradually worsening, although there is a lack of 02, or with co2 retention, but through the body compensation, can still engage in personal life Activity, called compensatory chronic respiratory failure. Once the respiratory infection is complicated, or the decompensation is caused by the increase of respiratory physiology burden for other reasons, the clinical manifestations of severe deficiency of 02, c02 retention and acidosis are called decompensated chronic respiratory failure.