Question

During resuscitation, a baby initially responds to PPV with a rapidly increasing heart rate. Subsequently, the baby's heart rate and oxygen saturation suddenly worsen. The baby has decreased breath sounds on the left side and transillumination reveals a bright glow. What is the most likely cause of this distress?

a. Obstruction of the endotracheal tube with thick secretions
b. Displacement of the endotracheal tube from the trachea into the esophagus
c. Choanal atresia
d. Left-sided pneumothorax

Answer 1

The most likely cause of the baby's distress during resuscitation, characterized by a worsening heart rate, oxygen saturation, and a bright glow on transillumination, is a left-sided pneumothorax.

Step-by-step explanation:

During resuscitation, if a baby initially responds to Positive Pressure Ventilation (PPV) with a rapidly increasing heart rate but subsequently exhibits a worsening heart rate and oxygen saturation, decreased breath sounds on one side, and a bright glow upon transillumination, the most likely cause of these symptoms is a left-sided pneumothorax. This condition occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse, which impairs breathing and oxygenation.