Pediatric Respiratory Failure Differential Diagnoses

  • Author: Shelley C Springer, MD, MBA, MSc, JD, FAAP; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Jan 27, 2012
 
 

Diagnostic Considerations

Problems to be considered in the differential diagnosis of pediatric respiratory failure include the following:

  • Guillain-Barré syndrome
  • Ludwig angina
  • Neuromuscular disorders (eg, Duchenne muscular dystrophy or spinal muscular atrophy [SMA] type 1)
  • Pulmonary embolus
  • Spinal cord injury
  • Tracheal foreign bodies
  • Transverse myelitis, cervical or high thoracic
  • Vascular slings

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Shelley C Springer, MD, MBA, MSc, JD, FAAP  Clinical Instructor, Department of Pediatrics, University of Vermont College of Medicine; Clinical Instructor, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health; Neonatologist, Pediatrix Medical Group; Assistant Clinical Professor, Department of Pediatrics, University of North Texas Science Center; Assistant Clinical Professor, Department of Pediatrics, Texas A&M Health Science Center College of Medicine

Shelley C Springer, MD, MBA, MSc, JD, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Margaret A Priestley, MD  Assistant Professor of Clinical Anesthesiology and Critical Care, University of Pennsylvania School of Medicine; Clinical Director, Pediatric Intensive Care Unit, The Children's Hospital of Philadelphia

Margaret A Priestley, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Jimmy W Huh, MD  Associate Professor of Anesthesiology, Critical Care and Pediatrics, Department of Anesthesiology and Critical Care Medicine, Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia

Jimmy W Huh, MD is a member of the following medical societies: American Academy of Pediatrics and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

References

  1. Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of respiratory illness in children and adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Jan.

  2. de Klerk A. Humidified high-flow nasal cannula: is it the new and improved CPAP?. Adv Neonatal Care. Apr 2008;8(2):98-106. [Medline].

  3. Ralstonia associated with Vapotherm oxygen delivery device--United States, 2005. MMWR Morb Mortal Wkly Rep. Oct 21 2005;54(41):1052-3. [Medline].

  4. Spence KL, Murphy D, Kilian C, McGonigle R, Kilani RA. High-flow nasal cannula as a device to provide continuous positive airway pressure in infants. J Perinatol. Dec 2007;27(12):772-5. [Medline].

  5. Campbell DM, Shah PS, Shah V, Kelly EN. Nasal continuous positive airway pressure from high flow cannula versus Infant Flow for Preterm infants. J Perinatol. Sep 2006;26(9):546-9. [Medline].

  6. Esteban A, Frutos-Vivar F, Ferguson ND, et al. Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med. Jun 10 2004;350(24):2452-60. [Medline].

  7. Habashi NM. Other approaches to open-lung ventilation: airway pressure release ventilation. Crit Care Med. Mar 2005;33(3 Suppl):S228-40. [Medline].

  8. Curley MA, Hibberd PL, Fineman LD, et al. Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial. JAMA. Jul 13 2005;294(2):229-37. [Medline].

  9. Willson DF, Thomas NJ, Markovitz BP, et al. Effect of exogenous surfactant (calfactant) in pediatric acute lung injury: a randomized controlled trial. JAMA. Jan 26 2005;293(4):470-6. [Medline]. [Full Text].

  10. Conrad SA, Rycus PT, Dalton H. Extracorporeal Life Support Registry Report 2004. ASAIO J. Jan-Feb 2005;51(1):4-10. [Medline].

  11. Children's Healthcare of Atlanta. Available at http://www.lchoa.org/childrens-hospital-services/critical-care/ECMO-center/Volumes-and-Outcomes. Accessed 14 January, 2012.

  12. Haines NM, Rycus PT, Zwischenberger JB, Bartlett RH, Undar A. Extracorporeal Life Support Registry Report 2008: neonatal and pediatric cardiac cases. ASAIO J. Jan-Feb 2009;55(1):111-6. [Medline].

  13. Extracorporeal Life Support Organization. H1N1 ECLS Registry, Statistics from the H1N1 Registry (as of May 28, 2010). Available at http://www.elso.med.umich.edu/H1N1Registry.html.

  14. Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, et al. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Crit Care Med. Aug 1999;27(8):1409-20. [Medline].

  15. Singer P, Shapiro H. Enteral omega-3 in acute respiratory distress syndrome. Curr Opin Clin Nutr Metab Care. Mar 2009;12(2):123-8. [Medline].

 
Previous
Next
 
Bilateral airspace infiltrates on chest radiograph film secondary to acute respiratory distress syndrome that resulted in respiratory failure.
Extensive left-lung pneumonia caused respiratory failure; the mechanism of hypoxia is intrapulmonary shunting.
A Bilevel positive airway pressure support machine is shown here. This could be used in spontaneous mode or timed mode (backup rate could be set).
Table 1. Survival Statistics from CHA, 2005-2009[11]
YearCHA (US)International
200558%54%
200647%53%
200771%56%
200857%54%
200975%55%
Table 2. 2009 Top 5 Diagnoses for ECMO and Survival Rates[11]
DiagnosisCHA (US)International
Bacterial pneumonia74%57%
Viral pneumonia78%63%
Aspiration pneumonia92%66%
Non-ARDS acute respiratory failure62%51%
Other65%52%
Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.