Pediatric emergency medicine trisk 1394 1394
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TABLE 71.4
MOST COMMON CAUSES OF RESPIRATORY DISTRESS
Neonates
Infants/children
Nasal obstruction
Congenital airway anomalies
Transient tachypnea
Respiratory distress syndrome
Meconium aspiration
Pneumonia
Sepsis
Congenital heart disease
Fever
Sepsis
Gastroenteritis/dehydration
Croup
Tracheitis
Foreign body
Bronchiolitis
Asthma
Anaphylaxis
Pneumonia
Disorders of the alveoli and interstitium involve pus or fluid collection,
collapse, and structural or functional abnormality. Alveolar and interstitial disease
is characterized by tachypnea, cough, grunting, crackles, rhonchi, wheeze, and
decreased and/or asymmetric breath sounds with or without fever. In neonates,
transient tachypnea of the newborn and meconium aspiration are common causes.
Pneumonia is one of the most common causes of lower airway disease in children
of all ages. Fever, hypoxemia, nasal flaring, tachypnea, and retractions are the key
predictors of pneumonia. Auscultatory findings are more likely to be localized in
the setting of bacterial pneumonia, whereas patients with viral and atypical
pneumonias (e.g., Mycoplasma infection, Chlamydia infection, and pertussis)
tend to have diffuse peribronchial, interstitial processes. Patients presenting
during epidemics of severe respiratory illness secondary to coronavirus infections
(e.g., SARS and MERS) also commonly have fever, chills, cough, and respiratory
distress which can be life threatening. Less commonly, aspiration, hemorrhage,
and pulmonary edema cause fluid collection in the acini and interstitium.
Atelectasis, or airway collapse, resulting from loss of air within the pulmonary
parenchyma often occurs secondary to other processes, including pneumonia,
particularly viral; bronchospasm; and inadequate lung expansion, most often
resulting from pain, neuromuscular disease, or inactivity. Structural and/or
