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Multiple Bilateral Perfusion Defects in the Infant with Acute Viral Bronchiolitis: A Case Report
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Woo Jin Chung, Jae Wook Choi, Young Ju Han, June Dong Park
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Korean J Crit Care Med. 2011;26(4):272-275.
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DOI: https://doi.org/10.4266/kjccm.2011.26.4.272
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 Abstract
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- Acute viral bronchiolitis (AVB) is an obstructive lung disease which frequently develops in infants and the most common functional involvement is a V/Q ratio change caused by small airway obstruction. We report a case showing the redistribution of pulmonary blood flow by multiple perfusion scan defects in an infant with AVB. A 15 month-old male infant visited ER due to respiratory difficulty. He manifested decreased lung sound in the left lung field, hyperinflation of the left lung on chest x-ray, and metabolic acidosis in blood gas analysis. A perfusion scan showed multiple perfusion defects of both lungs without the evidence of pulmonary embolism on a following cardiac CT and echocardiography. Human Rhinovirus PCR in a nasopharyngeal aspirate was positive. With supportive care, the symptom was resolved in 4 days. AVB can show multiple perfusion defects by the redistribution of pulmonary blood flow of which the direction is opposite to the usual distribution of pulmonary blood flow in children.
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Atelectasis and the Risk Factors in the Patients Admitted to Pediatric Intensive Care Unit
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Woo Jin Chung, Jae Wook Choi, Young Ju Han, Ju Kyung Lee, Dong In Suh, Young Yull Koh, June Dong Park
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Korean J Crit Care Med. 2011;26(4):238-244.
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DOI: https://doi.org/10.4266/kjccm.2011.26.4.238
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Abstract
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- BACKGROUND
Atelectasis is a state of a collapsed and non-aerated region of the lung parenchyma, which is otherwise normal. This condition is usually associated with pulmonary disorders. The purpose of this study is to analyze the incidence and risk factors of atelectasis in patients admitted to the pediatric intensive care unit (PICU).
METHODS
We retrospectively analyzed the clinical characteristics and chest radiography of 280 PICU patients under 18 years old. We analyzed the incidence and pattern of atelectasis and compared the incidence according to the phase and mode of mechanical ventilation. We compared the incidence of ventilator care need and respiratory disease in 93 atelectasis patients.
RESULTS
Atelectasis incidence was 33.2%. The age (4.9 +/- 4.4 years) was younger and the admission-duration (17.8 +/- 25.1 days) was significantly longer in atelectasis patients (p < 0.01). Ventilator care need and respiratory disease in atelectasis patients (86.0%, 66.7% respectively) was significantly higher than in non-atelectasis patients (62.6%, 43.3% respectively) (p < 0.01). Atelectasis incidence in ventilator-required patients and respiratory-diagnosed patients (40.6%, 43.4% respectively) was significantly higher than that in non ventilator-required patients and non respiratory-diagnosed patients (15.7%, 22.6% respectively) (p < 0.01). Atelectasis was more common in the right upper lobe (55.6%) and during or after ventilator care (62.6%) (p < 0.05). Atelectasis incidence in ventilator care did not differ between the assist-control and intermittent mandatory ventilation modes.
CONCLUSIONS
In the PICU, atelectasis incidence was higher in patients with ventilator care and respiratory disease.
Atelectasis was more common in the right upper lobe and in the phase after ventilator initiation. Atelectasis incidence in ventilator care did not differ between ventilation modes.
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