Acute respiratory failure in bronchiolitis and pneumonia in infancy. Modes of presentation and treatment

Area of Science:

• Pediatric critical care medicine
• Neonatology
• Infectious diseases in infants

Background:

• Severe lower respiratory tract infections pose a significant threat to infant health.
• Acute respiratory failure in infants presents with diverse and severe clinical manifestations.
• Respiratory Syncytial Virus (RSV) is a common pathogen in severe infant respiratory infections.

Purpose of the Study:

• To describe the presentation and management of acute respiratory failure in infants.
• To evaluate the role of intermittent positive-pressure ventilation (IPPV) in managing severe infant respiratory failure.
• To assess the mortality rate associated with severe lower respiratory tract infections in infants.

Main Methods:

• Retrospective analysis of 11 infants with severe lower respiratory tract infections.
• Documentation of clinical presentations leading to ventilatory failure.
• Measurement of pre-ventilation carbon dioxide levels.
• Assessment of the impact of intermittent positive-pressure ventilation on outcomes.

Main Results:

• Common presentations included progressive respiratory distress, exhaustion, circulatory collapse, apnea, and convulsions.
• Nine infants had pre-ventilation carbon dioxide levels exceeding 65 mm Hg, indicating severe ventilatory compromise.
• A low mortality rate of less than 0.5% was observed during the 15-month study period.

Conclusions:

• Intermittent positive-pressure ventilation likely played a crucial role in the low mortality observed.
• Prompt recognition and management of severe respiratory failure are essential for improving infant outcomes.
• RSV infections are a major contributor to severe respiratory illness and failure in infants.