A 780 gram male twin B infant who was 28 weeks at birth is n…
A 780 gram male twin B infant who was 28 weeks at birth is now 21 days of age and weighs 840 grams. He required intubation and ventilation at birth for minimal respiratory effort. He received a total of 3 doses of surfactant for RDS and he received a treatment course of indomethacin for a PDA. He had a UAC for 6 days. He was extubated on DOL 6, but was placed back on the ventilator on DOL 7 for multiple apneic episodes while on CPAP and caffeine. He was extubated a second time on DOL 14 and remains on CPAP. He has been started on feedings 3 times, each time having them stopped for abdominal distention. In each instance, an abdominal KUB film showed only mild dilation with an overall normal gas pattern and no pneumatosis or free air. After stooling, the distention would resolve and feedings would be restarted. He is now on feedings of premature formula at 60 ml/kg/day via continuous gavage feeding. You are called to his bedside to evaluate him while you are on night call, yet again, for abdominal distention. Select 4 of the most likely differential diagnoses prior to examining the patient.
Read Details