A Newborn Is Evaluated for Cyanosis Immediately After Birth

A newborn is evaluated for cyanosis immediately after birth.  On examination, oxygen saturation is 70% in all 4 extremities and does not change despite 100% oxygen administration.  The patient's lungs are clear to auscultation, and there are no heart murmurs or gallops.  Peripheral pulses are normal.  A chest radiograph reveals clear lungs and a normal cardiac silhouette but a narrowed mediastinal shadow.  Which of the following is the most likely cause of cyanosis in this patient?

A) Impaired alveolar-capillary diffusion
B) Impaired left ventricular contractility
C) Inability of hemoglobin to bind oxygen
D) Right-to-left cardiac shunting
E) Ventilation-perfusion mismatch

Correct Answer:

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