1mnth male child brought in emergency having severe respiratory distress with feeble peripheral pulses.H/o fever, cough, refusal to feed since last 4-5 days. Vitals- HR-159/MIN, RR- 76/MIN, SPO2-82-83%on O2. Manage with mechanical ventilation and inotropic support dobut@10& Adr@.15. Plz suggest management and DDX

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Do cbc crp blood c/s abg . Continue ventilation . Iv fluids iv antibiotics like amoxiclav and cefotaxime. If pulses were feeble u could have used dopamine instead of dobutamine . However u are using adrenaline too it will serve the purpose . Look for lactate level in abg . Xray shows left middle n lower lobe consolidation. In children for cardiomegaly intracardiac diameter should b more than 60 percent of intrathoracic diameter . There pot shaped heart do echocardiography to r/o pericardial effusion .

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Left lower lobe pneumonia With present scenario , COVID 19 has to be ruled out. Suggest ECG and ECHO and troponin, to rule out congenital heart diseases and COVID associated myocarditis and cardiac failure Ventilation, antibiotics, isotopic support needs to be continued.

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Left lower and middle love hazyness Cardiomegaly, liver enlarged (impending CCF) Use fluid judiciously, Abx ( piptaz , amikacin ) empirically Looks like compensated shock...with low BP, feeble pulse dopamine better choice.... sedation and ventilation Must do and Echo, blood c/s and ABG

Cardiomeagaly rt atreal.enlargement seen. Need to exclude congenital heart disease.pl treat cardiac failure. Paediatric cardiologist is a better person to msnage

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Lt mid & lower zone Pneumonitis Right lower zone pneumothorax I v fluids Iv Antibiotics ? COVID infection

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Cardiomegaly Rt hilar lymphadenopathy? Lt midzone haziness Pneumonitis Rest of lung fields are hyperinflated Iv piperacillin and tazobactum Ventilation to be continued with inotropics

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Lt lower lobe haziness suggest septic Pneumonitis. Broad spectrum antibiotics, O2 inhalation with nebulization. IV fluids and Corticosteriods Cbc, esr, Ur/m, Hrct chest, ABG

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Xray look CCF WITH CARDIOMAGALY. SUSPECTED CONGENITAL HEART DISEASE DO ECHO MOST PROBABLY. CCHD INTRA CARDIAC TAPVC MAY BE FALLOTS ECHO PLAN. AND START NORAD SUPPORT. WITH DOBUTAMINE 5 MCG PER HRS IV LASIX 5 MG 6 HRLY. START MEROPENAM 100 MG 8 HRLY IV TARGOCID 50. MG DAILY. DO ABG.

Avoid iv fluid u can start RT feed 20 ml 2 hlry
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Hyperinflated lung fields, cardiomegaly,left lower zone hazyness,

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Your heart rate is controlled by electrical signals that move across the heart muscle. When something goes wrong and signals are sent too quickly, it can cause tachycardia. Most patients with ventricular tachycardia have another heart problem, such as coronary artery disease, high blood pressure, an enlarged heart (cardiomyopathy) or heart valve disease. The condition can also develop after a heart attack (myocardial infarction) or heart surgery because of scar tissue that forms on the heart. Other, non-heart-related causes of ventricular tachycardia include some medications, an imbalance in electrolytes (the minerals that control heart rhythm), too much caffeine or alcohol, recreational drugs, exercise, and certain genetically transmitted conditions. Sometimes the cause is unknown. You are also more likely to have ventricular tachycardia as you get older or if you have a family history of heart rhythm disorders.

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