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Radiological Case of the Month

Raul F. Cifuentes, MD; Andre J. Nelson, MD; Adolfo Chuy, MD; Lionel W. Young, MD
Am J Dis Child. 1985;139(4):423-424. doi:10.1001/archpedi.1985.02140060105042.
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Because of suspected amnionitis, an 820-g female infant was born by cesarean section at 27 weeks' gestational age to a 16-year-old mother. The Apgar scores were 1 and 2 at one and five minutes, respectively. The initial blood gas values on ventilatory settings at peak pressures of 30 cm H2O, a positive end-expiratory pressure of 5 cm H2O, a respiratory rate of 50 breaths per minute, an inspiration-expiration ratio of 1:1, and a maximum fractional concentration of oxygen were as follows: pH, 7.27; carbon dioxide pressure, 47 mm Hg; and oxygen pressure, 62 mm Hg. The patient's course was downhill and she required increased ventilatory support, up to 60 cm H2O peak inspiratory pressure and a respiratory rate of 80 breaths per minute. However, she remained hypoxemic and hypercarbic. There was no response to tolazoline hydrochloride and dopamine hydrochloride, and the patient died shortly


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