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The Case:
A term infant with severe respiratory failure.
Prenatal History:
35-year-old gravida 4 para 3 mother
Blood type A-negative, rapid plasma reagin nonreactive, group B Streptococcus negative, hepatitis B surface antigen-negative, and antibody screen-negative
Membranes ruptured 5½ hours prior to delivery
Birth History and Presentation:
The infant was born by vaginal vertex delivery at 38 weeks gestational age. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. He developed respiratory distress shortly after delivery and was placed under an oxygen hood with 35% O2. A chest radiograph revealed ground glass appearance, consistent with respiratory distress syndrome.
Subsequent Course:
The infant was intubated and received three doses of surfactant via endotracheal tube. He was treated for 10 days with both conventional ventilation and high-frequency oscillatory …
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