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Question of the Week #33

In which of the following clinical scenarios would pulse pressure variation be MOST useful for the determination of volume status and fluid responsiveness?

A. Intubated septic patient in the Intensive Care Unit (ICU), on pressure support and in the process of being weaned off mechanical ventilation.

B. Spontaneously breathing patient in the ICU after successful Fontan procedure, on high flow nasal cannula.

C. Intubated patient in the cardiac ICU, mechanically ventilated with a volume-controlled mode of ventilation, after coarctation of the aorta repair.

D. Intubated and mechanically ventilated patient, volume-controlled mode of ventilation, presenting with major burns, sepsis, and atrial fibrillation.

A 2-day-old, 1.2 kg female neonate born prematurely at 28 weeks gestational age, has worsening tachypnea, intercostal retractions, and hypoxia. She is intubated after the failure of nasal continuous positive airway pressure (CPAP) and oxygen therapy. Which of the following chest x-ray findings is MOST indicative of respiratory distress syndrome (RDS) in this neonate?

A. Right lower lobe patchy infiltrates

B. Cardiomegaly and increased pulmonary vascular markings

C. Air bronchograms, decreased lung volumes, and diffuse ground-glass appearance

D. Left upper lobe opacity with central lucency

Question of the Week #31

Welcome to your Question of the Week #31

Which of the following is MOST LIKELY to occur as a long-term sequela of painful procedures in the neonate?

A. Decreased biological response to subsequent painful procedures.

B. Lower stimulated cortisol response levels initially, followed by a reset of the endocrine stress response with higher cortisol levels later in life.

C. Equal cognitive, motor skills and growth scores compared to controlled counterparts not exposed to repeated painful procedures.

D. Decreased risk of secondary hyperalgesia.

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