Pulmonary hyaline membranes and perinatal shock

Fibrinolysis in Pre‐term Infants and in Infants Small for Gestational Age

“…The investigation, together with a previous study (13), which showed that human foetuses have a considerable fibrinolytic activity despite low plasminogen values, argues against a primary deficiency of the fibrinolytic system in pre-term infants and infants small for gestational age. It does not support the hypothesis of such a deficiency being a factor in the pathogenesis of the idiopathic respiratory distress syndrome (3) or disseminated intravascular coagulation (7) in the newborn.…”

Morphologic Diagnosis of Disseminated Intravascular Coagulation: Histologic, Histochemical and Electronmicroscopic Studies

“…For a long time the pathogenesis and morphogenesis of pulmonary hyaline membranes were unknown. The unusual frequency of intravascular coagulation with consumption of coagulation factors, formation of intravascularly circulating fibrinogen-fibrin monomer complexes, and consecutive disseminated intravascular microthrombosis in the premature newborn, suffering from intrauterine asphyxia and dying with the symptoms of a respiratory distress syndrome in the perinatal period, led to an understanding of this morphogenesis [8,9,11]. The unusual frequency of intravascular microthrombi in these autopsy cases demonstrated that hypoxia and acidosis can induce circulatory shock, beginning in utero and persisting in the perinatal period.…”

“…The unusual frequency of intravascular microthrombi in these autopsy cases demonstrated that hypoxia and acidosis can induce circulatory shock, beginning in utero and persisting in the perinatal period. The respiratory distress syndrome of the premature newborn, caused by asphyxia, thus becomes a shock syndrome of the premature newborn induced by hypoxia and acidosis [9,11]. The lungs in the respiratory distress syndrome must be considered as shock lungs [8,11].…”

“…The respiratory distress syndrome of the premature newborn, caused by asphyxia, thus becomes a shock syndrome of the premature newborn induced by hypoxia and acidosis [9,11]. The lungs in the respiratory distress syndrome must be considered as shock lungs [8,11]. The simultaneous manifestation of disseminated intravascular microthrombi and pulmonary hyaline membranes in the respiratory distress syndrome of the premature newborn also raised the question of whether hyaline membranes of the lungs (in parallel to the findings of animal experiments mentioned above) can also be looked upon as morphologic evidence of generalized intravascular coagulation.…”

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“…194 ' 195 In addition, many patients with acute DIC develop typical pulmonary hyaline mem branes that account, in part, for the significant degree of pulmonary dysfunction and hypoxemia seen in these patients. 76,196,197 In this regard it should be noted that pure adult shock lung syndrome is most likely an organ-specific DIC-type pathophysiologic event that usually remains localized to the pulmonary bed. 2 Pe ripheral smear alterations typically seen in DIC are depicted in Table 13.…”