A MALE INFANT of 35 weeks' gestational age had mild respiratory distress shortly after birth. He weighed 2640 g after a pregnancy complicated by breech presentation and pregnancy-induced hypertension, resulting in a cesarean delivery with clear amniotic fluid and no risk factors for infection. Apgar scores were 7 and 8 at 1 and 5 minutes, respectively.
During transport to the newborn nursery, the infant became dusky, developed sternal retractions, and showed 81% oxygen saturation by pulse oximetry. He was afebrile, and findings from physical examination revealed tachypnea, subcostal retractions, and decreased breath sounds present on the left. Therapy was begun with delivery of supplemental oxygen by hood at a fraction of inspired oxygen of 35%. Levels for serial C-reactive proteins and complete blood cell count were normal as were findings from blood culture. Antibiotic therapy was started on admission to the intermediate care nursery. The arterial blood gas level 2 hours after birth showed a pH of 7.22; PaO2, 60 mm Hg; and PaCO2, 58 mm Hg. A chest radiograph was obtained and repeated 6 hours later (Figure 1 and Figure 2). Within 6 hours, after management by positioning in the left lateral decubitus position and delivery of oxygen by nasal cannula, the respiratory distress, hypercarbia, and acidosis had improved. The infant was discharged following 10 days of antibiotic therapy for presumed pneumonia.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Pediatrics editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 5
Customize your page view by dragging & repositioning the boxes below.
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.