Welcome to Cross-Canada Paediatric - Respiratory Residency Rounds
Page 1 / Case 11.02


Dr.Hussein Al Kindy MD
Respiratory Fellow, Montreal Children's Hospital
McGill University Health Center


A newborn with respiratory distress and low lung volume


A 3-day old baby boy was transferred from a level 3 Neonatal intensive care unit (NICU) for further evaluation. The presenting history consisted of respiratory distress in the first few minutes of life. The baby was cyanotic and hypotonic at 11 min of life. He improved with positive pressure ventilation with bag and mask.

Perinatal Hx
He was born by spontaneous vaginal delivery at 39 wks following an uneventful pregnancy to east Indian parents. The antenatal ultrasound at 33 wks showed bilateral talipes valgus. The birth weight was 3.275 kg. The Apgar score was 6 at 1 min, 7 at 5 min and 8 at 10 min.

Physical exam
No dysmorphism other than the talipes valgus was noted. Cardivascular system, abdominal, and neurological examinations were normal. The respiratory exam showed poor respiratory efforts, sub costal retractions, and nasal flaring. Auscultation disclosed was fair breath sounds and a few inspiratory crackles bilaterally. An inspiratory stridor was also noted. Pulse oximetry showed a SaO2 of 67% in room air and 97% with an FIO2 of 1.00.

A chest Xray was done.

ENLARGE the chest X-ray



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