The following is the summary of “Infant in extremis: respiratory failure secondary to lower airway infantile hemangioma” published in the December 2022 issue of Pediatrics by MacDougall, et al.

Infantile hemangiomas (IHs), are benign vascular tumors that typically disappear on their own or can be treated non-invasively with topical beta-blockers as an outpatient procedure. Infants are more likely to be affected by IHs. On the other hand, IHs present in the airway might create potentially fatal symptoms due to the airway’s obstruction or the risk of bleeding. In this paper, researchers provide the first ever documented instance of a newborn suffering from abrupt respiratory failure and fast deterioration due to a lower airway hemangioma.

This male infant, who was 3 months old at the time, originally came with respiratory distress and symptoms that were typical of a viral respiratory infection. Despite receiving routine therapy, the infant did not demonstrate any clinical improvement. An emergency computed tomography scan uncovered a tumor blocking the right mainstem bronchus. After being sent to a facility that provided tertiary care, he suddenly developed acute respiratory failure, which necessitated immediate intubation and ventilation of only 1 lung. Numerous subspecialists made it possible to stabilize a child in a serious condition, speed up the diagnosing process, and ultimately begin providing the youngster with beta-blockers, which ultimately saved their life. 

After 17 days spent in the hospital, he was successfully extubated and sent home in satisfactory condition. Researchers give several pearls for the general pediatrician about the care of inflammatory hyperplasias of the airway, despite the fact that IH is a very uncommon cause of infantile respiratory distress.