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A chest x-ray that doesn't look right
  1. Ravinder Parige,
  2. Simon Power
  1. Department of Neonatology, Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, UK
  1. Correspondence to Dr Ravinder Parige, 19 Old Worden Avenue, Buckshaw Village, Chorley, PR7 7DG; ravinderdoctor2004{at}

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A 29-week gestation female infant was born by spontaneous vaginal delivery with a birth weight of 1.180 kg. She received surfactant and was briefly ventilated on day 1 before extubation onto biphasic continuous positive airway pressure (BiPAP). On day 5, she was reintubated and ventilated in view of increasing respiratory distress and a moderate respiratory acidosis. A postintubation chest x-ray was taken (figure 1) and the endotracheal tube (ETT) was pulled back by 0.5 cm. Blood gases normalise promptly with minimal pressure ventilation; however, over the subsequent 12 h her oxygen requirements increase from 21% …

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  • Contributors Both authors contributed equally in designing the questions and writing the manuscript.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.