Pediatrics |

Diagnostic Difficulties in a Case of Neonatal Respiratory Distress FREE TO VIEW

Manuela Cucerea, PhD; Monika Rusneac, MD; Marta Simon, PhD; Carmen Movileanu, MD
Author and Funding Information

University of Medicine and Pharmacy, Targu Mures, Romania

Chest. 2014;145(3_MeetingAbstracts):449A. doi:10.1378/chest.1821427
Text Size: A A A
Published online


SESSION TITLE: Pediatric Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Neonatal respiratory distress is any difficulty in breathing during the first 28 days of life. Clinical manifestations include a wide range depending on gestational age and its triggering causes.

METHODS: we present the case of a newborn who manifested respiratory disorders due to intermittent intracranial hypertension, a case involving difficulties in establishing an accurate diagnosis and prognosis.

RESULTS: eutrophic term newborn, (birth weight 3500 gr, 39 weeks of gestational age) derived from monitorised pregnancy, birth by caesarean section, Apgar score 10 at 1 and 5 minutes. The clinical course was marked by progressive neurological and respiratory alterations, the newborn presenting laryngeal stridor, bradypnoe (20-30 breaths/minute), desaturation (70%), oxygendependency, seizures, apnea, vocal cord paralysis, requiring respiratory assistance. Neurological symptoms were characterised by cerebral cry, rowing movements, pedaling movements, generalized musculary hypotonia, drowsiness alternating with periods of marked psychomotor agitation, oral automatisms, vertical nystagmus. Laboratory examination revealed respiratory acidosis, normal chest X-ray, scratchy brain substance and high resistivity indices on anterior cerebral artery at transfontanellar Doppler ultrasound. Cerebrospinal fluid was hypertensive and MRI revealed a large left sylvian sulci and raised the suspicion of poly-microgyria. EEG was amended. Therapeutic plan included: oxygenation and SIMV ventilation, respiratory physiotherapy, fluid and metabolic rebalance, anticonvulsants, depletives, enteral nutrition by gavage, neuroroborants. In evolution, respiratory support was required for four weeks, sucking-swallowing coordination difficulties led to feeding difficulties, possibility of bottle feed accured after 6 weeks. The neurological status remained altered.

CONCLUSIONS: Difficulty of establishing the etiology of respiratory distress led to the need for complex multidisciplinary investigations enabling the correct treatment and long-term projection of a realistic prognosis.

CLINICAL IMPLICATIONS: a rare etiology of respiratory distress in neonates

DISCLOSURE: The following authors have nothing to disclose: Manuela Cucerea, Monika Rusneac, Marta Simon, Carmen Movileanu

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543