PMC10364471_01
(A) Initial presentation chest x-ray. (B) Pre-intubation x-ray with complicated pneumomediastinum. (C) Post intubation and post-peripheral VA-ECMO cannulation.
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F1
Initial chest radiographs demonstrated bilateral hyperinflation, no consolidation, and no radio-opaque FB (Figure 1A). After a period of relative stability with reduction in the work of breathing, a normalization of arterial CO2 levels, and minimal oxygen requirement, he deteriorated on day 3 of his admission with development of a pneumomediastinum (Figure 1B) and an acute rise in arterial CO2. He was intubated then cannulated to peripheral VA-ECMO through the right common carotid artery and the right internal jugular vein, due to inadequate oxygenation and ventilation on conventional mechanical ventilation (Figure 1C).
Pediatric intensive care unit timeline.
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F2
Clinically he is well and regaining previously attained motor milestones (Figure 2).