Neonatology · NEET PG Preparation Paediatrics
A 28-week preterm neonate, currently on mechanical ventilation, suddenly develops acute deterioration with asymmetric chest movements, decreased brea…
Practice question from Neonatology (NEET PG Preparation Paediatrics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-262A8F
A 28-week preterm neonate, currently on mechanical ventilation, suddenly develops acute deterioration with asymmetric chest movements, decreased breath sounds on the right hemithorax, bradycardia, and oxygen desaturation. Transillumination of the right chest shows increased brightness. What is the most immediate lifesaving intervention required?
- A.Immediate endotracheal extubation
- B.Administration of exogenous surfactant
- C.Emergency needle thoracostomy or chest tube insertion on the right sideCorrect answer
- D.High-frequency oscillatory ventilation
Solution
The clinical picture of acute deterioration, asymmetric chest expansion, absent breath sounds, and transillumination in a ventilated neonate strongly points towards a tension pneumothorax. This is a medical emergency requiring prompt needle decompression or chest tube placement before confirmatory imaging.
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