Question

A 1-month-old formerly premature male infant with BPD remains intubated and monitored in the NICU. He has been doing relatively well and is being gradually weaned from the respirator. Suddenly, his O2 saturations and heart rate plummet, and he becomes very dusky. On quick exam, there are decreased breath sounds on the right with an asymmetric chest rise.

What is the most likely explanation for his sudden respiratory and clinical change?

1. Inadequate tidal volume
2. A large leak around the tracheal tube
3. Displacement of the tracheal tube
4. Tension pneumothorax
5. Disconnected oxygen supply
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Answer 1

The most likely explanation for the sudden respiratory and clinical change in the 1-month-old infant is a tension pneumothorax. Common signs and symptoms include sudden respiratory distress, decreased breath sounds on the affected side, asymmetric chest rise, and cyanosis.

Step-by-step explanation:

The most likely explanation for the sudden respiratory and clinical change in the 1-month-old infant is a tension pneumothorax.

Tension pneumothorax occurs when air enters the pleural space between the lung and the chest wall and cannot escape. The trapped air causes increased pressure in the chest, which can compress the lungs, impairing their ability to expand and exchange oxygen and carbon dioxide.

Common signs and symptoms of tension pneumothorax include sudden respiratory distress, decreased breath sounds on the affected side, asymmetric chest rise, and cyanosis.