Successful Treatment of an Infant Case of Apnea Caused by Rhinovirus Infection with High-flow Nasal Cannula
10.14442/generalist.46.149
- VernacularTitle:ライノウイルス感染により顕在化した無呼吸発作に対してhigh-flow nasal cannulaが奏功した乳児例
- Author:
Yuri OKUNE
;
Yoshinori SUGIMINE
;
Yuka IKEDA
;
Mitsukazu MAMADA
;
Akira YOSHIDA
- Keywords:
laryngeal chemoreflex;
apnea;
infant;
oxygen inhalation therapy;
rhinovirus
- From:An Official Journal of the Japan Primary Care Association
2023;46(4):149-152
- CountryJapan
- Language:Japanese
-
Abstract:
The case involved a one-month-old male infant. Around two weeks after birth, cold-like symptoms were observed within the family. Over the course of approximately one month, the infant gradually developed coughing, apnea, and cyanosis, leading to a visit to a nearby medical facility. The episodes of apnea were initiated by a wet-sounding, choking cough. Respiratory pathogen multiplex screening revealed rhinovirus infection. The infant was managed in the intensive care unit and treated with a high-flow nasal cannula (HFNC), which resulted in an improvement of the recurrent episodes of apnea. We discontinued HFNC on the 7th day of hospitalization; however, the patient had recurrence of apnea. After relieving abdominal distension through rectal enema, the infant was successfully weaned off HFNC and discharged on the 14th day of hospitalization. In addition to the immaturity of the respiratory center in infants, laryngeal chemoreflex triggered by chemical receptors in the larynx is known to contribute to apnea. In the present case, we considered that the reduction of respiratory effort through HFNC, the expectorant effect of warmed and humidified air, and the decrease in gastroesophageal reflux due to alleviation of abdominal distension played roles in the successful outcome.
