Related Experiment Video
Updated: Apr 12, 2026
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
Adenovirus pneumonia complicated with acute respiratory distress syndrome: a case report
1From the Department of Pediatrics (K-HH, L-HL), Cathay General Hospital, Taipei; and School of Medicine (L-HL), Fu-Jen Catholic University, New Taipei City, Taiwan.
Insights
Severe adenovirus pneumonia in children can cause acute respiratory distress syndrome (ARDS). Early extracorporeal membrane oxygenation (ECMO) with high-frequency oscillatory ventilation (HFOV) can be life-saving for pediatric ARDS patients.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Respiratory medicine
Background:
- Severe adenovirus infection in children can lead to acute respiratory distress syndrome (ARDS) and respiratory failure.
- Mechanical ventilation or extracorporeal life support (ECLS) may be required for prolonged periods.
- Early extracorporeal membrane oxygenation (ECMO) intervention is recommended for pediatric ARDS patients meeting specific criteria.
Observation:
- A 9-month-old boy with adenovirus pneumonia (serotype 7 confirmed) rapidly progressed to ARDS.
- Conventional ARDS therapies were ineffective.
- Chest X-rays showed progressive bilateral lung infiltrations and pleural effusions over 11 days.
Findings:
- ECMO combined with high-frequency oscillatory ventilation (HFOV) was initiated for 9 days.
- Gradual improvement in lung expansion was observed on chest X-rays.
- The patient was discharged after 38 days, with outpatient follow-up for post-ECMO and adenovirus sequelae.
Implications:
- Adenovirus pneumonia can cause significant pulmonary morbidity and respiratory failure in children.
- The combination of HFOV for lung recruitment and ECMO for lung rest offers a viable therapeutic strategy for severe pediatric ARDS.
- This case highlights the potential benefit of early ECMO and HFOV in managing severe adenovirus-induced ARDS in children.
Abstract:
Severe adenovirus infection in children can manifest with acute respiratory distress syndrome (ARDS) and respiratory failure, leading to the need for prolonged mechanical support in the form of either mechanical ventilation or extracorporeal life support. Early extracorporeal membrane oxygenation (ECMO) intervention for children with ARDS should be considered if selection criteria fulfill.We report on a 9-month-old boy who had adenovirus pneumonia with rapid progression to ARDS. Real-time polymerase chain reaction tests of sputum and pleural effusion samples confirmed adenovirus serotype 7. Chest x-rays showed progressively increasing infiltrations and pleural effusions in both lung fields within 11 days. Because conventional ARDS therapies failed, we initiated ECMO with high-frequency oscillatory ventilation (HFOV) for 9 days. Chest x-rays showed gradual improvements in lung expansion.This patient was subsequently discharged after a hospital stay of 38 days. Post-ECMO and adenovirus sequelae were followed in our outpatient department.Adenovirus pneumonia in children can manifest with severe pulmonary morbidity and respiratory failure. The unique lung recruitment by HFOV can be a useful therapeutic option for severe ARDS patients when combined with sufficient lung rest provided by ECMO.
