Skip to content

Assembly

Hypoxemia in a Premature Child

Author
JOHN BISHARA
Professional Certification(s): DO
Affiliation: Pediatric Pulmonary Fellow; Winthrop University Hospital


Case

A 6-month-old male with a history of prematurity (born at 29-weeks gestation), bronchopulmonary dysplasia with hypoxemia on oxygen supplementation, was hospitalized three times for episodes of hypoxemia and respiratory distress over a span of two months. Workup for worsening hypoxemia revealed gastroesophageal reflux disease and dysphagia with aspiration (confirmed via pH MI probe and fluoroscopic swallow study). The patient was also noted to develop significant apnea with administration of anesthesia. Further evaluation included polysomnography, and a representative 90-second epoch is pictured below. What is the diagnosis?

a representative 90-second epoch of polysomnography

Overall AHI was 67.8/hr, with a central AHI 18.8/hr; NREM AHI 43.5/hr and REM AHI 24.3/hr

Question

What is your diagnosis?

A. Worsening hypoxemia secondary to bronchopulmonary dysplasia
B. Respiratory failure secondary to bronchopulmonary dysplasia
C. Aspiration causing lung injury
D. Congenital Central Hypoventilation Syndrome

Answer