A 19-month-old boy with recurrent respiratory distress

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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
06:15

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Published on: March 6, 2019

Keith P Cross1, Kimberly A Randell, Sandra M Herr

  • 1Division of Emergency Medicine, Department of Pediatrics, Kosair Children's Hospital, University of Louisville, Louisville, KY, USA. keith.cross@louisville.edu

Pediatric Emergency Care
|February 11, 2010
PubMed

Insights

A toddler with asthma experienced persistent noisy breathing and rapid breathing. Doctors discovered a low bicarbonate level, indicating a potential metabolic issue beyond typical asthma exacerbation.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Physiology
  • Clinical Diagnostics

Background:

  • Asthma is a common chronic respiratory disease in children.
  • Albuterol is a standard bronchodilator for asthma exacerbations.
  • Persistent respiratory distress requires thorough investigation.

Observation:

  • A 19-month-old boy with asthma presented with noisy breathing and tachypnea.
  • Initial albuterol treatment provided only partial relief.
  • The child returned the next day with ongoing respiratory distress.

Findings:

  • Despite albuterol, respiratory symptoms persisted.
  • Electrolyte analysis revealed a significantly low bicarbonate level.
  • This suggests a possible metabolic acidosis contributing to respiratory symptoms.

Implications:

  • Low bicarbonate levels in pediatric respiratory distress warrant further investigation beyond asthma.
  • Metabolic acidosis can mimic or exacerbate respiratory conditions.
  • Early identification of metabolic derangements is crucial for appropriate pediatric care.

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