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Spare hypoxia, spoil the child?
Jason Boehme, Emin Maltepe
Jason Boehme, Emin Maltepe
Published March 2, 2015; First published February 17, 2015
Citation Information: J Clin Invest. 2015;125(3):965-967. https://doi.org/10.1172/JCI80820.
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Category: The Attending Physician

Spare hypoxia, spoil the child?

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Abstract

Clinical vignette: An 8-year-old boy presents to the pediatric ICU after two days of cough with increasing secretions. The patient is progressing to respiratory failure and requires noninvasive mechanical ventilation. His past medical history is remarkable for premature birth at 25 and 6/7 weeks gestational age, cerebral palsy, developmental delay, epilepsy, and gastrostomy tube dependence. His chest x-ray is remarkable for multifocal opacities that are consistent with atelectasis. A complete blood count reveals a wbc count of 9.2 with a normal differential, Hg of 11.7, and platelet count of 276,000. A respiratory viral panel from a nasal swab returns positive for rhinovirus. Additional patient history from the parents uncovers that he has been hospitalized three times over the course of the past 2 years with a similar presentation.

Authors

Jason Boehme, Emin Maltepe

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Figure 1

Types of brain injuries frequently encountered in premature neonates.

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Types of brain injuries frequently encountered in premature neonates.
Pr...
Premature infants are prone to a variety of brain injuries. (A) A cross section of a healthy brain shows areas that are associated with injuries of prematurity. (B) The most common injury is noncystic PVL, which presents as a diffuse cerebral white-matter injury (orange) accompanied by microscopic focal necrotic lesions. (C) Cystic PVL is a more severe disease that, in addition to diffuse white-matter injury, presents with macroscopic necrotic lesions. (D) IVH, which occurs with much less frequency than PVL in premature infants, is characterized by bleeding (red) into the ventricular system of the brain. (E) The most extreme cases of IVH are associated with periventricular hemorrhagic infarction into the white matter.
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