Abstract

A female neonate born at 23 weeks’ gestation presents with worsening respiratory distress 9 days after birth. ### Prenatal and Birth Histories ### Initial Hospital Course The infant was initially placed on a conventional ventilator. The infant received 2 doses of surfactant and was then extubated to high-flow nasal cannula. She remained in a cannula for 36 hours and was then reintubated for worsening respiratory status and development of respiratory acidosis. She was then placed on high-frequency oscillatory ventilation (HFOV). ### Presentation (Day 9) On day 9 after birth, the infant had persistent and severe respiratory acidosis, prompting chest radiography. The infant’s radiograph on day 9 is shown in …

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