A 4 years old child is admitted in the ward with pneumonia. He develops sudden respiratory distress. The following chest X-ray was recorded. What will you do next?
A. Decrease mechanical ventilation
B. Increase mechanical ventilation
C. Intercostal chest drainage tube insertion
D. Immediate needle thoracostomy
Ans: A. Decrease mechanical ventilation
(Ref Ghai 8/e p393)
- Findings are indicative of the child developing acute respiratory distress syndrome as a result of volutrauma.
- Hence, decreasing mechanical ventilator settings is the management of choice.
- Volutrauma may be manifested acutely as pulmonary air leak, such as pneumothorax, pneumomediastinum, pulmonary interstitial emphysema, and bronchopleural fistula.
- Cause of chronic repetitive lung injury, exacerbating the primary disease.