PMC8577950_01
Erect (a) anteroposterior and (b) lateral chest X-rays taken for this patient prior to using the EIT device. These films were read by the attending pediatric radiologist: "On the lateral view both the lungs appear hyperinflated. There is relative decreased lung volume on the frontal view which is felt to be related to patient rotation."
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Erect anteroposterior and lateral chest X-rays (Figure 1) were read by the pediatric radiologist as "...both lungs appear hyperinflated. ...decreased lung volume on the frontal view which is felt to be related to patient rotation." The patient was enrolled in a prospective research study which used EIT to measure the effects of HFNC on minute ventilation in children with bronchiolitis. On initiation of EIT (Figure 2, Video 1), he had near-normal right lung ventilation (98%) and nearly absent left lung ventilation (2%).
(a) EIT ventilation map for the patient showing right lung ventilation and (b) the EIT ventilation distribution showing 98% of ventilation occurring on the right lung. Figure axes include anterior lung fields (A), posterior lung fields (P), right lung (R), and left lung (L).
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On initiation of EIT (Figure 2, Video 1), he had near-normal right lung ventilation (98%) and nearly absent left lung ventilation (2%).
(a) Right and (b) left lateral decubitus chest X-rays taken after the EIT device was used in attempt to confirm diagnosis of FBA by more traditional means. The attending pediatric radiologist read these images: "Both lungs are hyperinflated on the decubitus view without significant asymmetry which suggests air trapping secondary to bronchiolitis."
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The decubitus films (Figure 3) were read: "Both lungs are hyperinflated on the decubitus view without significant asymmetry which suggests air trapping secondary to bronchiolitis." Lung ultrasounds were read: "Motion was seen at the bilateral hemidiaphragms, with more motion of the right hemidiaphragm as compared to left."
Images taken from diagnostic bronchoscopy, displaying a peanut causing near-complete occlusion of the left mainstem bronchus (LMB) and granulation tissue in the right mainstem bronchus (RMB). The RMB granulation tissue suggesting the peanut had recently moved, potentially after coughing, leading to the acute deterioration. The peanut was subsequently removed and the patient improved rapidly.
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Otolaryngology was consulted and subsequently performed a rigid bronchoscopy, where a peanut was found to be occluding the left mainstem bronchus (LMB) (Figure 4).