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April 1985

Radiological Case of the Month

Author Affiliations

Contributed from the Departments of Pediatrics (Drs Cifuentes and Nelson) and Radiology (Dr Chuy), Hennepin County Medical Center and the University of Minnesota, Minneapolis.

Am J Dis Child. 1985;139(4):423-424. doi:10.1001/archpedi.1985.02140060105042

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