Respirator Management in Hyaline Membrane Disease

PEDIATRICS ◽  
1970 ◽  
Vol 46 (2) ◽  
pp. 313-314
Author(s):  
Leo Stern
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Positive Pressure ◽  
College Hospital ◽  
Recent Increase ◽  
Hyaline Membrane ◽  
University College ◽  
The Subject

Experiences with the use of mechanical sistance to respiration in severe hyaline membrane disease or respiratory distress syndrome (RDS), have resulted in a recent increase in papers dealing with the subject.1-6 To these is now added the report of Reynolds7 appearing in this issue, detailing such an experience with a Bennett (positive pressure) respirator at University College Hospital in London. In evaluating the applicability to other centers of such reports, it is necessary to bear in mind some variables which may profoundly influence the results and which would appear virtually impossible to standardize.

STUDIES ON HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (1) ◽  
pp. 10-24
Author(s):  
Clara M. Ambrus ◽  
David H. Weintraub ◽  
Donal Dunphy ◽  
John E. Dowd ◽  
John W. Pickren ◽  
...  
Keyword(s):  
Placebo Group ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Plasminogen Activator ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Blood Coagulation Factors ◽  
Plasminogen Activator Activity ◽  
Hyaline Membrane

In the serum of normal prematures and premature infants with respiratory distress syndrome, plasminogen was absent. In mature newborns plasminogen levels were low, as compared to adults. In the euglobulin fraction of plasma, plasminogen level was highest in mature newborns, lower in healthy prematures, and lowest in prematures with respiratory distress syndrome. Antiplasmin level was exceptionally high in about a fourth of the premature infants with or without respiratory distress syndrome. Plasminogen activator activity was found more often in the blood of infants with respiratory distress syndrome than in normal infants. This may be due to the liberation of tissue activators as a consequence of hypoxia. Because of the absence of the substrate (plasminogen), this activator level may have no significance. Tissue activator activity was found in the lungs of premature infants whether they died of hyaline membrane disease or from other causes. Forty-five infants with respiratory distress were treated in a therapeutic study. Twelve were treated in a preliminary series and 33 in a randomizd, double-blind investigation. Of the latter, 11 were treated with placebo, and 5 (45%) survived; 8 were treated with streptokinase activated human plasmin and 2 (25%) survived; 14 were treated with urokinase activated human plasmin and 12 (86%) survived. Among the infants who died, no definite hyaline membrane disease was found by histopathologic examination in two of the placebo group, one in the streptokinase-plasmin treated group, and the two who died in the urokinase-plasmin group. No significant side-effects of plasmin therapy were seen. Although considerable fibrinolytic and plasminogen-activator activity was generated in many treated patients, there was no significant fall in blood coagulation factors. Intracerebral hemorrhage, which appears to occur often in patients who die with hyaline membrane disease, was not more frequent in the plasmintreated group than in the placebo group.

The Magnitude and Risk Factors of Acute Respiratory Distress Syndrome among Newborn Admitted To Neonatal Intensive Care Unit at Benghazi Medical Center

2021 ◽  
pp. 41-61
Author(s):  
Munera Awad Radwan ◽  
Najia Abdelati El-Mansori ◽  
Mufeda Ali Elfergani ◽  
Mohanad Abdulhadi Lawgali
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Medical Center ◽  
Female Gender ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

Background: Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS) is the most common lung condition affecting premature babies. The inadequate amount of surfactant causes alveoli to collapse when the baby breathes out. It is hard for your baby to re-inflate the collapsed alveoli when he breathes. The lack of surfactant and resulting inflammation is called. Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS). Aim of the Study: To determine the magnitude of Hyaline membrane disease or respiratory distress syndrome and identify the risk factors and complication among newborn babies in neonatal intensive care unit at Benghazi medical center (BMC). Materials and Methods: Case series study. The study was conducted during the period between March 2017 to March 2018 of HMD cases at Benghazi medical center. A convenient sample of 120 cases diagnosed as HMD. Studied variables include the following; gestational age, birth weight, gender, type of pregnancy and type of delivery also the data for mothers such as (diabetes mellitus, preeclampsia hypothyroidism, receiving of Dexamethasone injection and premature rupture of membrane). Also investigation and treatment and finally the outcomes of babies. Statistical Methods: Data were analyzed with SPSS version 17, analysis of associations was made with application Chi - square test for categorical variables comparison, was applied for test of association P <0.25. P was considered statistically significant if ≤ 0.05. Results: Female gender was predominant (52%). Most of cases of HMD were between 1000 -2000 kg. Among the 120 cases we have (15%) sever HMD and the majority of cases have moderate –to sever Hyaline membrane disease 39 (32.5%) whereas very sever HMD were observed in nearly 27% of cases. The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis, all these were found to be very common risk factors of HMD. Pearson chi-square test p value highly significant of female gender with complications of HMD. Our results observed more than half of babies were died. Conclusion: The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis all these were found to be very common risk factors of HMD. Also we concluded that the cases had premature rupture of membrane, which identified as risk factors of hyaline membrane disease. Furthermore, we concluded that highly significant of female gender with complications of HMD, such as Pneumothorax, bronco pulmonary, dysplasia, intra ventricular hemorrhage and congenital heart diseases were common co- morbidities with respiratory distress syndrome, all these could be have an association with the development of hyaline membrane disease, finally we observed more than half of babies were died this is a warning sign for health services.

scholarly journals Complicated delivery in a patient with acute respiratory distress syndrome on Coronavirus disease 2019 infection

2020 ◽  
Author(s):  
Alexis Bikfalvi ◽  
Aleksandar Dabetic ◽  
Moira Robertson
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Caesarean Section ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Invasive Ventilation ◽  
Hyaline Membrane ◽  
Return Home

A 39-year-old parturient contracted COVID-19 at 28 weeks of gestation and later developed ARDS requiring emergent caesarean section, intubation and 11 days of invasive ventilation. Her infant also required intubation due to hyaline membrane disease, he was not infected by COVID-19. Both evolved well and could return home.

scholarly journals Air Leak in Neonatal Respiratory Distress Syndrome

1984 ◽  
Vol 12 (1) ◽  
pp. 41-45 ◽  
Author(s):  
P. D. Sly ◽  
J. H. Drew
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Maternity Hospital ◽  
Assisted Ventilation ◽  
Air Leak ◽  
Mechanical Ventilators ◽  
Hyaline Membrane ◽  
Neonatal Respiratory Distress

A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. Air leak developed in 22% of infants with respiratory distress, 8% had pulmonary interstitial emphysema alone, 14% had pneumomediastinum or pneumothorax and 7% had emphysema with pneumomediastinum or pneumothorax. Mortality increased from 12% in infants without air leak to 31% (p < 0.001) in infants with air leak. Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.

Studies on the Prevention of Respiratory Distress Syndrome of Infants Due to Hyaline Membrane Disease with Plasminogen

2008 ◽  
Vol 2 (01) ◽  
pp. 42-51 ◽  
Author(s):  
Clara Ambrus ◽  
Thai Choi ◽  
David Weintraub ◽  
Bernard Eisenberg ◽  
Henry Staub ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

STUDIES ON HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1966 ◽  
Vol 38 (2) ◽  
pp. 231-243
Author(s):  
Clara M. Ambrus ◽  
David H. Weintraub ◽  
Julian L. Ambrus
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Treated Group ◽  
Control Group ◽  
Hyaline Membrane ◽  
The Difference ◽  
The Uk ◽  
Experimental Group

Fibrinolytic enzyme therapy of respiratory distress syndrome was explored in a controlled, randomized, double-blind clinical study. Of 100 infants entered in the study, 60 corresponded to all of the predetermined criteria and were included in the final evaluation. Infants with respiratory distress syndrome were admitted to the study if they were (1) premature, (2) from diabetic mothers, or (3) from mothers with hemorrhagic complications of pregnancy. In regard to sex, delivery route, maternal status, pretreatment respiratory rate, Silverman score, venous pressure, electrolytes, protein levels, and circulating levels of members of the fibrinolysin system, the placebo-treated control group and the experimental group were found to be comparable. The groups were comparable in regard to pretreatment blood pH and pCO2 as well, except that the subgroup that was treated with the enzyme preparation and expired showed a greater degree of acidosis than the other groups. Patients in the experimental group received 5 RPMI units/kg of human plasmin activated with human urokinase (UK-plasmin) intravenously in 4 hours, plus 60 RPMI units/kg/day of enzyme by aerosol. In the placebo-treated control group, 11 of 28 infants recovered (39%) and in the UK-plasmin treated group, 23 of 32 recovered (72%). The difference is statistically significant at less than 5% level. Of the infants with a birth weight of 2 kg or less, 3 of 16 recovered in the placebo-treated control group (19%), and 10 of 16 recovered in the UK-plasmin treated group (63%); the difference is statistically significant at less than 5% level. No clinical side effects were seen in any of the patients. Autopsy findings indicated a high degree accuracy of diagnosis. The incidence of hemorrhage diagnosed at autopsy was the same in the control and experimental groups. In all but one of the patients that expired in the UK-plasmin treated group, sufficient pathologic findings were obtained to account for death regardless of the presence of hyaline membrane disease. Similar findings were obtained in 9 of 17 patients who expired in the control group. UK-plasmin therapy of respiratory distress syndrome of infants due to hyaline membrane disease appears to be worthy of further exploration. A diagram correlates certain features of the pathophysiology of this disease and the mechanism of action of therapy.

EOSINOPHILS IN THE THYMUS IN HYALINE MEMBRANE DISEASE (RESPIRATORY DISTRESS SYNDROME)

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 205-214
Author(s):  
Maurice M. Black ◽  
Aldo G. Baldi
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Perinatal Death ◽  
Hyaline Membrane Disease ◽  
Axillary Lymph Nodes ◽  
Control Group ◽  
Axillary Lymph ◽  
Hyaline Membrane ◽  
Made In

An examination was made of the prominence of perivascular aggregates of eosinophilic leukocytes in thymic septa of cases of respiratory distress syndrome (hyaline membrane disease). Similar examinations were also made in cases of stillbirth and perinatal death unassociated with hyaline membrane disease. Moderate or marked thymic eosinophilia was found in more than 70% of 27 cases of hyaline membrane disease. This degree of eosinophilia was encountered in less than 10% of the control group. Numerous eosinophils were also found in the axillary lymph nodes of four of eight cases of hyaline membrane disease, but in only 2 of 20 control cases. The data are considered in terms of their relationship to adrenocorticoid levels in the fetus and the pathogenesis of hyaline membrane disease.

Letter to the Editor

PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 468-468
Author(s):  
R. William Provenzano
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory System ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Beneficial Effects ◽  
Letter To The Editor ◽  
Hyaline Membrane ◽  
Adrenal Hypoplasia

It was with great interest and pleasure that I read the article written by Naeye, et al.,1 the Commentary by Reynolds and the Letter to the Editor by Tow3 describing the successful use of steroids in hyaline membrane disease. The use of adreno-cortical extract in pediatrics, its beneficial effects in adrenal hypoplasia of the newborn,4 on the respiratory system of the newborn,5 and its possible use in atelectasis6 (a term previously used to describe the respiratory distress syndrome and now termed hyaline membrane disease), was reported in 1950, 1951, and 1952.

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