Unconventional management approach to a life-threatening neonatal respiratory condition

A steroid-exposed 1100g infant of 27+3 weeks’ gestation was born by emergency caesarean section for maternal COVID-19 pneumonitis. He required ventilation and surfactant administration at birth but continued needing ventilatory support despite a further dose of surfactant and an unsuccessful trial on continuous positive airway pressure (CPAP). It became increasingly difficult to oxygenate and ventilate him adequately, and with progressively worsening chest X-ray changes (figure 1), he warranted transfer to the nearest neonatal intensive care unit (NICU) as per national guidelines.1 2 Questions What are the most striking features on this X-ray? Hyperinflation of the right lung, honeycomb appearance of the lung field, mediastinal shift to the left. Right-sided tension pneumothorax with mediastinal shift to the left. Bilateral ground-glass changes, worse on the right, with mediastinal shift to the left. Collapse of the left lung causing mediastinal...
Source: Archives of Disease in Childhood - Education and Practice - Category: Pediatrics Authors: Tags: COVID-19 Epilogue Source Type: research