Case #10 - Respiratory Failure in a 7-Month-Old Black Female

Authors: Sabina Ali, MD; Rosa A Vidal, MD; Sheryl Falkos, MDSeries Editors: Rosa A Vidal, MD; Sheryl Falkos, MD

Disclosures

June 23, 2004

Discussion

The patient required mechanical ventilation for 10 days. During this time she received daily treatments with bronchodilators, mucolytics, and chest physiotherapy. She was extubated on Day 10 of hospitalization without complications, placed on supplemental O2 by nasal cannula, and was successfully weaned to room air prior to discharge on Day 14. She was continued on the same respiratory treatments after discharge.

The infant was started on empiric antibiotics on admission that were tailored to culture results and continued for 14 days. Her respiratory cultures were positive for Staphylococcus aureus, a common pathogen found in the lungs of children with CF.

She was started on total parental nutrition on admission to the pediatric intensive care unit, and subsequently begun on high-calorie formula and treated with pancreatic enzymes. At the time of discharge, the patient was tolerating her formula well and had gained 500 grams.

The infant's cranial ultrasound showed evidence of atrophy. This was most likely due to her severe malnutrition. She will need to be closely followed by her primary care physician in her home state to determine whether she is meeting developmental milestones. She will also need additional long-term follow-up with pediatric pulmonary and gastrointestinal specialists.

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