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May 1, 2024

An 18-month-old infant with a dilated cardiomyopathy undergoes heart transplantation, receiving a heart from a 3-year-old

An 18-month-old infant with a dilated cardiomyopathy undergoes heart transplantation, receiving a heart from a 3-year-old child twice his weight. The early posttransplant recovery goes well, and he weans from cardiac pressor agents and is extubated. He has a mediastinal drainage tube in place. As the respiratory therapist, you are called because the chest radiograph shows left lower lobe consolidation, and auscultation reveals a monophonic expiratory wheeze. Sao2 is 95% on 1 LPM oxygen supplementation. There is a mild increase in work of breathing. Which intervention would you recommend? 1. Reintubation with positive pressure breathing 2. Nebulized albuterol 3. Trial of nasal continuous positive airway pressure 4. Urgent flexible bronchoscopy 5. Chest computed tomography CT scan 6. None of the Above

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