ETCO2 is positive, bilateral chest rise and breath sounds. Pulse oximetry rapidly drops to the 70's. Patient rapidly re-intubated with a 7.5 ETT resulting in a positive ETCO2. Chest rise and breath sounds are better, huge tidal volumes are delivered, saturations come into the 90's. Patient requires a PIP of 35 and a PEEP of 10 to maintain sats.
Peripheral pulses are better after two liters.
CXR shows RUL consolidation and diffuse alveolar infiltrates. Tracheal aspirates reveal non-typeable H. influenzae. Patient survives after three weeks on the ventilator. Unusual cause of acute urinary retention in a child. Appendiceal abcess and urinary retention.