What is ARDS in children? Acute respiratory distress syndrome (ARDS) occurs in children, so the “A” was changed from adult to acute . It is a common cause of respiratory failure at all ages. ARDS is a diffuse pulmonary process that develops after lung injury. Some causes of ARDS that are treated in EDs include sepsis, hypotension, pneumonia, aspiration …
What is the value of a chest radiograph in evaluation of a child with suspected respiratory failure? In previously healthy children, respiratory failure is generally preceded by clinically identifiable respiratory distress. Young children with fever and tachypnea may benefit from a chest radiograph, because bacterial pneumonia can be difficult to diagnose by history and physical …
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Why do some patients with wheezing have a reduction in their oxygen saturation after bronchodilator treatment when they otherwise appear to be improving? Albuterol and other bronchodilators are β-adrenergic agents that are somewhat β 2 selective. β 2 -Receptor stimulation causes vaso dilation as well as broncho dilation. One explanation for decreases in oxygen saturation after treatment with bronchodilators is that pulmonary vasodilation …
What if the oxygen saturation is 2% to 3% below normal? The relationship between P o 2 and saturation is not linear but sigmoidal. Although there is little difference in P o 2 between saturations of 99% and 96%, there is a much greater difference in P o 2 between 93% and 90%. Oxygen saturation and respiratory rate are objective measures of pulmonary function …
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Episodes of desaturation that occur only while the child is feeding or sleeping? Oxygen saturation during feeding or while sleeping often dips below the baseline. Feeding and sleeping may be stress tests for desaturation. Normal children monitored during sleep have occasional oxygen saturation nadirs below 93%, and even dipping below 90% is not uncommon. In …
Episodes of desaturation that occur only while the child is feeding or sleeping Read More »
Are oxygen desaturations that only last for a few seconds significant? Probably not. Pulse oximeters display an oxygen saturation that is an average over a period of time. The technology was first developed for intraoperative monitoring, when beat-to-beat saturation readings are desirable, not for use in EDs and offices to predict respiratory deterioration. Most instruments …
Are oxygen desaturations that only last for a few seconds significant Read More »
What is the lowest acceptable oxygen saturation for a child to be discharged? There is often no simple answer to what appears to be a simple question. In healthy awake children a normal oxygen saturation is 97% to 99%. A saturation below 95% is greater than two standard deviations below the mean (− 2 SD). …
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