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Chapter 40 - A Floppy Breathless Child

Published online by Cambridge University Press:  17 December 2021

By
Sam Fosker  and
Shelley Riphagen
Edited by
Shelley Riphagen  and
Sam Fosker
Shelley Riphagen
Affiliation:
Evelina Children’s Hospital, London and South Thames Retrieval Service
Sam Fosker
Affiliation:
Evelina Children’s Hospital, London
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Summary

A 2-year-old girl with known spinal muscular atrophy (SMA) was referred with a 3-day history of worsening tachypnoea and increasing lethargy. She was no longer tolerating feeds and had visible mild intercostal and subcostal recession. Initially the child had improved on high flow nasal cannula (HFNC); however, oxygen requirements gradually increased to FiO2 of 0.64 in 3 L/kg HFNC by the time of referral.

Type
Chapter
Information
Cases in Paediatric Critical Care Transfer and Retrieval Medicine , pp. 221 - 226
Publisher: Cambridge University Press
Print publication year: 2022

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References

Further Reading

Davidson, AC, Banham, S, Elliot, M, et al. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure. Thorax 2016;71:ii1–ii35.CrossRefGoogle ScholarPubMed
Farrell, PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Ped Anaes 2004;14(1):84–9Google ScholarPubMed
Hull, J, Aniapravan, R, Chan, E, et al. British Thoracic Society guideline for respiratory management of children with neuromuscular weakness. Thorax 2012;67:i1–40.CrossRefGoogle ScholarPubMed
Zhao, H, Wang, H, Sun, F, et al. High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis. Crit Care 2017;21(1):184, doi: 10.1186/s13054-017-1760-8.CrossRefGoogle ScholarPubMed

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