The Relationship between Hyaline Membranes of the Newborn and the Presence of Other Pulmonary Lesions

Robertson, Bengt

doi:10.1111/j.1651-2227.1963.tb04309.x

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…This report suggests many similarities with the actual pandemic situation and describes similar autoptic findings with the central histologic hallmark, namely the presence of the hyaline membranes, which were known to represent fibrin deposition [ 132 , 133 ] and has been reported not only in premature children but also in human adults [ 133 , 134 , 135 , 136 ]. As it was described by Fujikura [ 132 ], fibrin deposition can be observed not only in the lungs of newborns but also in normal-term placenta [ 135 ].…”

Section: First Viral Acute Respiratory Distress Syndrome As Post-infl...supporting

confidence: 58%

SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death

Ramadori

2022

Medical Sciences

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SARS-CoV-2-infected symptomatic patients often suffer from high fever and loss of appetite which are responsible for the deficit of fluids and of protein intake. Many patients admitted to the emergency room are, therefore, hypovolemic and hypoproteinemic and often suffer from respiratory distress accompanied by ground glass opacities in the CT scan of the lungs. Ischemic damage in the lung capillaries is responsible for the microscopic hallmark, diffuse alveolar damage (DAD) characterized by hyaline membrane formation, fluid invasion of the alveoli, and progressive arrest of blood flow in the pulmonary vessels. The consequences are progressive congestion, increase in lung weight, and progressive hypoxia (progressive severity of ARDS). Sequestration of blood in the lungs worsens hypovolemia and ischemia in different organs. This is most probably responsible for the recruitment of inflammatory cells into the ischemic peripheral tissues, the release of acute-phase mediators, and for the persistence of elevated serum levels of positive acute-phase markers and of hypoalbuminemia. Autopsy studies have been performed mostly in patients who died in the ICU after SARS-CoV-2 infection because of progressive acute respiratory distress syndrome (ARDS). In the death certification charts, after respiratory insufficiency, hypovolemic heart failure should be mentioned as the main cause of death.

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Section: First Viral Acute Respiratory Distress Syndrome As Post-infl...supporting

confidence: 58%

SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death

Ramadori

2022

Medical Sciences

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“…The intensity of these changes was assessed according to the criteria given by ROBERTSON (1963). Severe hemorrhage (grade III) was encountered only among subjects living 3 to 5 days, while grades 0, I, and II occurred from the age of 1 to 2 days, and exceptionally at 5 to 6 days.…”

Section: Resultsmentioning

confidence: 99%

“…According to POTTER (1952), inflammation was usually noted in the lungs of infants with hyaline membrane disease who died after 48 hours. ROBERTSON (1963), in a histologic study of the relationship between pulmonary hyaline membranes and co-existing pulmonary lesions in the immediate neonatal period, reported that the incidence of complicating pneumonia and hemorrhage increased with postnatal age. Significant co-existing pulmonary lesions, such as pneumonia or hemorrhage, were demonstrated histologically in one or several lobes of the lungs in six of the roentgenologically atypical, and in twenty-one of the control cases, in the present material.…”

Section: Discussionmentioning

confidence: 96%

Atypical Roentgen Appearances of the Lung in Hyaline Membrane Disease of the Newborn

Rudhe¹,

Margolin²,

Robertson³

1970

Acta Radiologica. Diagnosis

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“…In fact,most of the discussions concentrated on the microscopic finding of diffuse alveolar damage (DAD) with the presence of hyaline membranes within the alveoli which has been considered to be the hallmark of ARDS and of the previous Respiratory Distress Syndrome in children and adults (23,(104)(105)(106)(107)(108)(109)(110) independently of the etiology of ARDS.…”

Section: Acute Respiratory Distress Syndrome (Ards):definition and Po...mentioning

confidence: 99%

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

Ramadori¹

2022

Preprint

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Two years after first patients approached the emergency rooms of hospitals in Wuhan becouse of respiratory distress,thousend of SARS-CoV-2 infected persons continue to die every day worldwide.SARS-CoV-2-infected patients undergo a process of dehydration and malnutrition before they develop respiratory problems and approach the emergency room of a hospital.This is,in many cases, the consequence of high fever which causes massive loss of fluids. In addition loss of appetite, is responsible for the deficit of protein intake.Most of the virus-infected patients admitted to the emergency room are therefore hypovolemic and hypoproteinemic and suffer of respiratory distress accompanied by ground grass opacities at CT-scan of the lungs.Critically ill patients are treated following the guidelines for treatment of septic shock but with &bdquo;conservative“ fluid replacement and administration of diuretics to assure sufficient hourly urine production. The combination of conservative fluid administration with reduced protein content in the enterally administered diet, together with administration of diuretics, has severe hemodynamic consequenses in mostly aged,dehydrated,critically ill patients. Many of them will develop acute kidney injury in the next 24 hours.In most of the cases, patients continue to loose weight by loosing skeletal muscle mass. Ischemic damage in the lung capillaries is responsible for the acute respiratory distreass syndrome (ARDS) and for the hallmark of autoptic findings,diffuse alveolar damage (DAD) characterized by hyaline membrane formation,fluid invasion of the alveoli recruitment of some inflammatory cells and progressive arrest of blood flow in the pulmonary vessels.The consequence is progressive congestion , increase of lung weight and progressive hypoxia (progressive severity of ARDS).Sequestration of blood in the lungs worsen hypovolemia and ischemia in different organs.This is most probably responsible for recruitment of inflammatory cells and for persistance of elevated serum levels of positive acute-phase markers and of hypoalbuminemia. Autoptic studies have been performed mostly in patients who died in the ICU after SARS-CoV-2-infection because of progessive ARDS.In those patients, tubulus epithelium necrosis in the kidney is a frequent finding as it has been the case in the first SARS-CoV-1 pandemic.In the death certification charts, many times weeks after first symptoms have started ,cardiac arrest is the cause of death after respitatory insufficiency.Replacement therapy with sufficient amount of fluid and albumin should be part of the early individualized life-saving supportive measures avoiding mechanical ventilation.

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The Relationship between Hyaline Membranes of the Newborn and the Presence of Other Pulmonary Lesions

Cited by 11 publications

References 9 publications

SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death

SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death

Atypical Roentgen Appearances of the Lung in Hyaline Membrane Disease of the Newborn

SARS-CoV-2-Infection (COVID-19): Clinical Course and Cause(s) of Death

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