Severe Hypercapnia Requiring 48-h Whole-Body Hypothermia in an Infant with Acute Bronchiolitis
Bronchiolitis is a clinical syndrome involving the lower respiratory tract of infants and young children. The majority of patients recover using adequate hydration and oxygen (O<sub>2</sub>) therapy, while a small number of patients require ventilatory assistance. Beyond these therapeuti...
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| Main Authors: | , , , , , , , |
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| Format: | Book |
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MDPI AG,
2022-09-01T00:00:00Z.
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| Summary: | Bronchiolitis is a clinical syndrome involving the lower respiratory tract of infants and young children. The majority of patients recover using adequate hydration and oxygen (O<sub>2</sub>) therapy, while a small number of patients require ventilatory assistance. Beyond these therapeutical approaches, there are no available strategies for patients that do not improve. Hypothermia is a measure used to prevent neonatal hypoxic-ischemic encephalopathy by preventing carbon dioxide (CO<sub>2</sub>) production and subsequent tissue damage. Other medical applications of hypothermia have been proposed, such as in acute respiratory failure and necrotizing colitis. <b>Case report:</b> We report the case of a 50-day-old girl hospitalized with severe bronchiolitis caused by respiratory syncytial virus. On admission, the girl presented severe hypercapnic respiratory failure, requiring intubation and ventilatory support with conventional and non-conventional systems. However, the patient's general conditions worsened with elevated O<sub>2</sub> demand, thus whole-body hypothermia was attempted and performed for 48 h, with a gradual improvement in the respiratory function. No adverse effects were detected. <b>Conclusions:</b> Whole-body hypothermia could have a critical role as a rescue treatment in infants affected by severe hypercapnic respiratory failure, at the expense of few and rare side effects (bradycardia, coagulopathy, hyperglycemia). Notably, beyond reducing CO<sub>2</sub> production, whole-body hypothermia might have an impact in restoring lung function in newborns using bronchiolitis refractory to maximal medical therapy and invasive ventilation. |
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| Item Description: | 10.3390/children9091339 2227-9067 |