Hyaline Membrane Disease: I: Cellular Changes

Gandy, Gillian; Jacobson, W.; Gairdner, Douglas

doi:10.1136/adc.45.241.289

Cited by 66 publications

(21 citation statements)

References 38 publications

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“…We think that changes in COP reflect a redistribution of water between vascular and interstitial compartments with decreasing extravasation of fluid and protein into the peripheral and lung tissue. This is in agreement with the fact that infants with RDS are hypoproteinemic and edematous [24,25], while healthy pre term infants are much less edematous. Weight loss was smaller in infants with PROM than in premature infants and in infants with RDS.…”

Section: Discussionsupporting

confidence: 78%

Postnatal Changes in Colloid Osmotic Pressure in Premature Infants: In Healthy Infants, in Infants with Respiratory Distress Syndrome, and in Infants Born to Mothers with Premature Rupture of Membranes

Ekblad¹

1987

Gynecol Obstet Invest

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Colloid osmotic pressure (COP) of blood plasma during the first 4 days of life was measured in 63 neonates: 16 healthy preterm infants, 36 infants with respiratory distress syndrome (RDS), and 11 infants born to mothers with premature rupture of membranes. The relation between COP and total protein content of blood was significant in all groups over times from 1–3 h to 96 h. COP rose significantly by the age of 3 h compared to COP of umbilical cord plasma in all groups investigated. Infants with RDS showed a significant increase in COP during the investigation period. In healthy preterm infants the increase was less significant. In infants with RDS there was a negative correlation between changes in COP and body weight not seen in the other groups investigated. COP in neonates seems to reflect the compartmentation between vascular and interstitial spaces. Measurement of COP could be clinically useful in assessing hemodynamic adaptation after birth and also in assessing edema formation and water balance in infants with RDS.

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Section: Discussionsupporting

confidence: 78%

Postnatal Changes in Colloid Osmotic Pressure in Premature Infants: In Healthy Infants, in Infants with Respiratory Distress Syndrome, and in Infants Born to Mothers with Premature Rupture of Membranes

Ekblad¹

1987

Gynecol Obstet Invest

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“…Bronchiolar epithelial lesions, similar to those documented in the present study, have been described in lambs [7,8] and in human babies [4,5] after a few minutes of sponta neous ventilation. We conclude that the spontaneously breathing, prematurely deliv ered rabbit neonate might serve as a model for studies of the early stage of epithelial lung lesions due to surfactant deficiency.…”

Section: Discussionsupporting

confidence: 70%

“…Necrosis and desquamation of bronchiolar epithelium begin to appear within only a few minutes of spontaneous breathing [4,5] and probably become aggra vated by artificial ventilation [6]. Identical lesions are found in artificially ventilated premature newborn experimental animals [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Bronchiolar Epithelial Lesions in Spontaneously Breathing Premature Newborn Rabbits

Nilsson¹,

Robertson²

1985

Neonatology

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Premature rabbit neonates were stimulated to breathe for time periods varying between 5 and 150 min. The distribution of bronchiolar epithelial lesions was determined morphometrically. Animals breathing for 5–10 min had no lesions. Focal necrosis and desquamation of bronchiolar epithelium were found in 36 of 46 animals breathing for 15–150 min. These lesions were similar to those previously observed in premature rabbit neonates after a few minutes of artificial ventilation.

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“…The abdomen was immediately The spcctruln of structural abnorrnalitics that characterize the opened, and the blood vcsscls of the uterus were c l a~i~p c d with lungs of infants dying from the neonatal RDS includes necrosis a large hemostat. The fetuses were delivered through random and dcsquamation of the bronchiolar epithelium (5,6,21). This uterine incisions and weighed.…”

Section: Kgmentioning

confidence: 99%

Lung Surfactant and the Pathogenesis of Neonatal Bronchiolar Lesions Induced by Artificial Ventilation

1978

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P e d i a t . Res. 12: 249-255 (1978) Bronchiolar lesions n e w b o r n intermittent positive pressure respiratory distress s y n d r o m e ventilation (IPPV) bronchiolar epithelium, whereas such lesions were scarce or T , obtain the honlo~ogous surfactant suspension, we washed absent in surfactant-treated animals. Our findings indicate that the lungs of adult rabbits using a to an lung compliance of the premature neonate can be increased by endotrachcal cannula, ~h~ lavage fluid was first centrifuged at deposition of surfactant in the upper airways before the onset of 200 x g and 20" for 5 mi" to remove cellular contamination. ventilation, and that deposition of surfactant prevents the devel-then centrifuged at 1000 x and 40 for 1 hr, hi^ procedure opment of bronchiolar epithelial lesions in premature neonates yields a white in surpace-active phosp~olipids subjected to IPPV.(2). The pellets were resuspended in an equal volumc of supernatant. then pooled and frozen until used for deposition. SpeculationThe phospholipid content of the surfactant pool used in thc present experiments was 8.4 mg/rnl, the lecithin content 6.9 mg/ The possibility that administration of supplementary surfac-m l . tant might serve as a prophylaxis against RDS and against epithelial lesions induced by artificial ventilation should be further evaluated in animal experiments and the clinical appli-ARTIFICIAL VENTILATION O F FETUSES cation of analogous prophylactic measures considered, once ~h , experiments were carried Out on 1 6 premature fetuses, synthetic surfactant suspensions with optimal phospholipid (or obtained from 8 does. We killed the doe, 27 days less 1-3 hr phospholipid-protein) composition have been defined. after mating (full term = 31 t 1 day). by intravenous injection of 2 ml Mebumal (sodium pentobarbital. 6 0 rng/ml) and 5 ml potassium chloride (1 50 mg/ml). The abdomen was immediately The spcctruln of structural abnorrnalitics that characterize the opened, and the blood vcsscls of the uterus were c l a~i~p c d with lungs of infants dying from the neonatal RDS includes necrosis a large hemostat. The fetuses were delivered through random and dcsquamation of the bronchiolar epithelium (5,6,21). This uterine incisions and weighed. We used two fetuses from each feature, which is particularly prominent in very immature infants doe, one for deposition of surfactant and one serving as control. who die from RDS within a few hours after birth. is part of the Body weight in surfactant-treated animals ranged between 26"natural" course of the disease, i.e.,it is not restricted to patients and 34 g ( j ( = 31, S D = 3), and in controls between 27 and 3 8 receiving artificial ventilation. However, when a patient with g (k = 31. SD = 3). Within a few seconds after delivery the severe RDS develops the complication known as "bronchopulfetuses received an intraperitoneal injection of 0.6 mg Mebuman monary dysplasia," the degree of bronchiolar epithelial lesions and 0.02 mg Pavulon (pancuronium bromide). In order to appears to be cor...

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Hyaline Membrane Disease: I: Cellular Changes

Cited by 66 publications

References 38 publications

Postnatal Changes in Colloid Osmotic Pressure in Premature Infants: In Healthy Infants, in Infants with Respiratory Distress Syndrome, and in Infants Born to Mothers with Premature Rupture of Membranes

Postnatal Changes in Colloid Osmotic Pressure in Premature Infants: In Healthy Infants, in Infants with Respiratory Distress Syndrome, and in Infants Born to Mothers with Premature Rupture of Membranes

Bronchiolar Epithelial Lesions in Spontaneously Breathing Premature Newborn Rabbits

Lung Surfactant and the Pathogenesis of Neonatal Bronchiolar Lesions Induced by Artificial Ventilation

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