Visual Diagnosis: Newborn with Respiratory Distress
| Autor: | James A. Lee, Andrew J. Delle Donne, Maribel M. Morgan |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Parenteral Nutrition
medicine.medical_specialty Iatrogenic Disease Hematocrit medicine.disease_cause Tachypnea Pericardial Effusion Hypoxemia Diagnosis Differential 03 medical and health sciences 0302 clinical medicine medicine Humans Neonatology Respiratory Distress Syndrome Newborn medicine.diagnostic_test Respiratory distress business.industry Infant Newborn Capillary refill medicine.disease Pleural Effusion Respiratory acidosis 030228 respiratory system Anesthesia Pediatrics Perinatology and Child Health Female 030211 gastroenterology & hepatology medicine.symptom business Nasal cannula |
| Zdroj: | Pediatrics In Review. 39:e38-e41 |
| ISSN: | 1526-3347 0191-9601 |
| DOI: | 10.1542/pir.2016-0188 |
| Popis: | 1. James A. Lee, MD, Capt USAF MC*,†,‡ 2. Andrew J. Delle Donne, DO, LT USN MC*,†,§ 3. Maribel M. Morgan, MD, Maj USAF MC*,†,§,¶ 1. *San Antonio Uniformed Services Health Education Consortium, 2. †San Antonio Military Medical Center, 3. ‡Department of Pediatrics, 4. §Department of Neonatology, and 5. ¶Neonatal Intensive Care Unit, San Antonio Military Medical Center, Fort Sam Houston, TX This is the case of a small-for-gestational age (1,455 g) girl born at 35 weeks. She is twin B of a monochorionic, diamniotic twin gestation, born via induced vaginal delivery for acute-onset oligohydramnios in the setting of intrauterine growth restriction. The maternal medical history is significant for depression, idiopathic hypothyroidism (treated with levothyroxine during pregnancy), and obesity. Maternal serologies were negative. Results of routine prenatal echocardiography were normal. After routine resuscitation, the infant receives respiratory support via humidified high-flow oxygen via nasal cannula and umbilical venous catheterization (UVC) for parenteral nutrition. The infant is weaned to room air and continued on a combination of parenteral and enteral nutrition going into the third day of life. At 50 hours after birth, the patient develops acute respiratory distress. The physical examination is remarkable for signs of respiratory distress, including tachypnea, hypoxemia, nasal flaring, and decreased breath sounds on auscultation (specifically in the right lower lung fields). She has distant heart sounds, no murmur, normal pulses and capillary refill, and a soft, nondistended abdomen. Laboratory evaluation includes a white blood cell count of 7,400×/μL (7.4×109/L), a hematocrit value of 53%, a platelet count of 215×103/μL (215×109/L), a capillary blood gas sample (pH of 7.18, partial pressure of carbon dioxide of 64 mm Hg, partial pressure of oxygen of 32 mm Hg, bicarbonate of 22 mEq/L [22 mmol/L], base deficit of 7.3 mEq/L [7.3 mmol/L]), and a C-reactive protein level less than 0.3 mg/L ( |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|