Case Study

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Viral Induced Wheeze -- PCCU Case

Stage 1: Post-Intubation Blood Gas

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A 21-month-old admitted to DGH with difficulty in breathing and reduced oral intake. Wheeze requiring Atrovent and salbutamol nebulisers. CXR: right-sided consolidation. Escalation through HFNO, CPAP, then intubated and ventilated on 3rd attempt. PMHx: Born at 35/40, previous admission for wheeze Dec 23 requiring O2 but no PCCU, family history of asthma, developmental milestones achieved.

Clinical Data

history: Difficulty in breathing, reduced oral intake, progressive escalation from HFNO to CPAP to intubation (3rd attempt)

observations

Ppeak: 35

FiO2: 1

blood gas

type: ART

pH: 6.9

pCO2: 13.6

pO2: 14.5

HCO3: 15.3

BE: 11.7

lactate: 0.7

units: kPa

pmhx: Born 35/40, previous wheeze admission Dec 23, FHx asthma

Decision Point

What are your thoughts on this blood gas?