Pulmonary Hyaline Membranes: Killer or Protector

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 639-640
Author(s):  
Toshio Fujikura
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Significance ◽  
Cause Of Death ◽  
Distress Syndrome ◽  
Postmortem Examination ◽  
Fibrinolytic Enzymes ◽  
Definite Evidence ◽  
Neonatal Deaths ◽  
Hyaline Membranes

It is unfortunate that the clinical significance of hyaline membranes has been overempha-sized in the respiratory distress syndrome. Membranes are confirmed always in neonatal deaths at postmortem examination and there is very little information regarding the membranes among surviving infants who have suffered from the syndrome. Although some investigators have tried to dissolve the membranes with fibrinolytic enzymes, there is no definite evidence that the membranes are responsible for the direct cause of death and the syndrome.

scholarly journals Epidemiology of Cause of Death in Pediatric Acute Respiratory Distress Syndrome

2018 ◽  
Vol 46 (11) ◽  
pp. 1811-1819 ◽  
Author(s):  
Jasmine C. Dowell ◽  
Kaushik Parvathaneni ◽  
Neal J. Thomas ◽  
Robinder G. Khemani ◽  
Nadir Yehya
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cause Of Death ◽  
Distress Syndrome

scholarly journals Immediate Outcome of Mechanically Ventilated Neonates: Experience from a Tertiary Care Hospital

2016 ◽  
Vol 6 (1) ◽  
pp. 22-25
Author(s):  
Amrita Lal Halder ◽  
Md Abdul Baki ◽  
Nazmun Nahar ◽  
Tahmina Begum
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cause Of Death ◽  
Distress Syndrome ◽  
Perinatal Asphyxia ◽  
Common Reason ◽  
Fatality Rate ◽  
Common Complication

Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation.Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death.Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%).Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxiaBirdem Med J 2016; 6(1): 22-25

RESPIRATORY DISTRESS SYNDROME

2008 ◽  
Vol 19 (3) ◽  
pp. 203-225 ◽  
Author(s):  
ANNE GREENOUGH ◽  
VADIVELAM MURTHY
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Management Strategies ◽  
Hyaline Membrane Disease ◽  
Evidence Base ◽  
Diagnostic Techniques ◽  
Antenatal Corticosteroids ◽  
Hyaline Membranes ◽  
Respiratory Outcomes

Respiratory Distress Syndrome (RDS) is due to immaturity of the lungs, primarily the surfactant synthesising system; hence, the risk of RDS is inversely proportional to gestational age. The incidence of RDS has been reduced by the routine use of both antenatal corticosteroids and postnatal surfactant, but still approximately one per cent of babies develop RDS. Hyaline membranes, formed from plasma proteins which have leaked onto the lung surface through damaged capillaries and endothelial cells, line the terminal airways. Hence, RDS has also been called hyaline membrane disease, but RDS is the preferred name as the presence of hyaline membranes can only be confirmed histologically. The aim of this review is to emphasize the pathophysiology of RDS and the clinical presentation and relevance of diagnostic techniques in the current population of very prematurely born infants, highlighting the differential diagnosis. In addition, the evidence base for prophylactic and management strategies including whether new therapies and techniques of respiratory support have positively impacted on outcomes are discussed. The mortality and long term morbidity associated with very premature birth are described. Our increasing understanding that the so-called new bronchopulmonary dysplasia (BPD) and associated chronic adverse respiratory outcomes in such infants can reflect antenatal events resulting in abnormal lung growth is highlighted.

scholarly journals Factors Associated with Increased Neonatal Deaths at a Regional Hospital in Namibia

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Million Bimerew ◽  
Saara K. Hatupopi ◽  
Jennifer Chipps
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Distress Syndrome ◽  
Congenital Abnormalities ◽  
Survey Design ◽  
Birth Asphyxia ◽  
Regional Hospital ◽  
Record Keeping ◽  
Neonatal Deaths

The increased neonatal mortality rate in a regional hospital in Namibia is a concern. According to the 2013 records of the hospital, there were 333 neonatal deaths from 1 January to 31 December 2013. The aim of the study was to investigate the causes of the increased neonatal deaths at this regional hospital in Namibia. A retrospective descriptive survey design was employed to conduct the study. Data were collected from 231 record files of neonates that died from 1 January to 31 December 2013 while admitted at the regional hospital before 28 completed days of life. The results shows that 67.1 per cent (n = 155) neonates that died in the regional hospital were during the first 7 days of life, and 32.9 per cent (n = 76) died after 7 days of life but before 28 completed days of life. Five causes accounted for the early neonatal deaths: respiratory distress syndrome, congenital abnormalities, neonatal sepsis, birth asphyxia, and haemorrhagic diseases of newborns. The late neonatal deaths were mainly caused by neonatal sepsis, followed by respiratory distress syndrome, congenital abnormalities, and birth asphyxia. The results also indicated poor record-keeping as an associated factor in this regional hospital. The study finally concluded that the majority of neonatal deaths that occurred in 2013 at the regional hospital were associated with multiple factors such as respiratory distress syndrome, neonatal sepsis, asphyxia, and congenital abnormalities. However, the majority of these factors could have been avoided.

scholarly journals Descriptive study for neonatal death in neonatal care unit in maternity and children teaching hospital in Aldiwaniah, Iraq

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Abdulaziz Wannas Abd ◽  
Mahmood Jasim Mohammed
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Teaching Hospital ◽  
Neonatal Death ◽  
Distress Syndrome ◽  
Neonatal Care ◽  
Common Cause ◽  
Neonatal Deaths ◽  
Neonatal Care Unit

Of the estimated 130 million infants born each year worldwide,1 4 million die in the first 28 days of life. Three-quarters of neonatal deaths occur in the first week, and more than one-quarter occur in the first 24 hours.1,2 Neonatal deaths account for 40% of deaths under the age of 5 years worldwide. This study was descriptive-analytical prospective one and the population of the study included all infants hospitalized in NICU of maternity and children teaching hospital in aldiwaniah governorate from first of  September 2013  to the end  of august 2014.  About 1644 neonate  patients was  admitted to the neonatal care unit directly either from the labor room or from the operation room and the neonate only in contact with health personnel ; from those we study all  193  hospitalized neonates that  died due to different causes. In this study, of 1466 neonates , were hospitalized in NICU (neonatal intensive care unit ) in maternity and children teaching hospital from first of  September  2013 through  august  2014 ;  from which 193 ( 13.1%  )cases were died . A total of 193infants died in the hospital form which 64.25%  were male and ( 35.75% )of them were female. ; 36.8% of them were full term  and 63.2 % were premature . the most common cause of the neonatal death were the RDS (respiratory distress syndrome) 93 (48.1%) and the second most common cause were the complication of prematurity other than the RDS which form55( 28.4%  ). The birth asphyxia, congenital anomalies and sepsis represent 15 ( 7.7 %  ),  8 (4.1%) , 11 ( 5.6% ) respectively. the meconium aspiration syndrome mainly in postmature infant represent about 9 (4.6 % )and miscellaneous causes( hydrops fetalis and intraventriculer haemorrhage and congenital heart disease ) was 3  ( 1.5 %) .  The common cause of neonatal death was sever immaturity with its complications and mainly the respiratory distress syndrome. Almost the death occur in premature and LBW babies. We can prevent of born these babies by high quality prenatal care. The study proves the relations between certains maternal and neonatal factors and neonatal mortality; since low-weight premature infants are at more risk of dying in infancy, it is suggested that pregnant mothers should be placed under the required cares to avoid the birth of premature infants as possible.

BILATERAL VAGOTOMY AND PULMONARY HYALINE MEMBRANE FORMATION

PEDIATRICS ◽  
1965 ◽  
Vol 36 (2) ◽  
pp. 173-182
Author(s):  
Paul S. Milley ◽  
Louis J. Casarett
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Recurrent Laryngeal Nerve ◽  
Distress Syndrome ◽  
Laryngeal Nerve ◽  
Recurrent Nerve ◽  
Nerve Section ◽  
Membrane Formation ◽  
Hyaline Membranes ◽  
Hyaline Membrane

Bilateral midcervical vagotomy in adult and newborn rabbits results in the formation of pulmonary hyaline membranes similar to those observed in newborn infants dying of the respiratory distress syndrome. There are, however, important differences in the histopathology of the two conditions. Twenty adult rabbits survived unilateral right-sided cervical vagotomy for 30 days, but the majority died with hyaline membranes soon after the remaining left vagus was cut. Survival times were generally longer in animals in which the right recurrent laryngeal nerve was intact. Bilateral recurrent laryngeal nerve section resulted in death and pulmonary edema, but no hyaline membrane formation. Ten rabbits survived section of distal vagal fibers. Subsequent recurrent nerve section in 5 of these resulted in hyaline membrane formation not seen in sacrificed controls. Vagotomy-induced hyaline membrane formation appears to depend on loss of both recurrent laryngeal and distal vagal fibers, the former being more important. While there may be no relationship between experimental vagotomy and the respiratory distress syndrome, these experiments raise the possibility of an upper airway disorder in the clinical disease.

The Northwestern University Multihospital Twin Study. II. Mortality of First Versus Second Twins

1979 ◽  
Vol 28 (4) ◽  
pp. 347-352 ◽  
Author(s):  
R.F. Ellis ◽  
Gary S. Berger ◽  
Louis Keith ◽  
Richard Depp
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cause Of Death ◽  
Twin Study ◽  
Distress Syndrome ◽  
Northwestern University ◽  
Special Respect

The results of a multihospital study involving a total of 588 twin pairs born in Chicago in 1970–1975 are reported, with special respect to differences in mortality between first and second twins by time as well as by cause of death. Mortality was higher in second than in first twins and most commonly occurred after delivery and was the result of immaturity and of respiratory distress syndrome.

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