Pediatric Respiratory Failure Case Demonstration & Pathophysiology Review
7-month-old boy with fever, rhinorrhea, dyspnea, and signs of respiratory distress. Positive for RSV with peribronchial cuffing on CxR. Develops worsening respiratory failure after oxygen therapy. Pathophysiology of respiratory failure includes low FiO2, hypoventilation, diffusion abnormalities, V/Q mismatch, and shunting.
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Presentation Transcript
Pediatric Respiratory Failure : Case demonstration, Pathophysiology review . . . .
7-month-old boy Fever, rhinorrhea 4 days Dyspnea 2 days HR 150 bpm, RR 52/min, BP 104/84 mmHg, SpO292% room air. Intercostal and subcostal retraction bilateral wheezing.
CxR : peribronchial cuffing and slight hyperinflation, suggestive of viral pneumonia. RSV positive. TPRC : http://emrems.com/2013/01/
After oxygen therapy Agitated, flushing, HR 168, RR 68/min, SpO292% on 3 L of oxygen canula. Increased work of breathing, nasal flaring, grunting, head bobbing, and significant retraction. Transfer to ICU ; ABG : pH 7.16, PaCO270 mmHg. PaO270 mmHg
Pathophysiology of Respiratory failure Low FiO2 Hypoventilation Diffusion Dead space V/Q mismatch Shunt
