Chronic Pulmonary Insufficiency of Prematurity (CPIP)

PEDIATRICS ◽  
1975 ◽  
Vol 55 (1) ◽  
pp. 55-58
Author(s):  
Alfred N. Krauss ◽  
David B. Klain ◽  
Peter A. M. Auld
Keyword(s):  
Mortality Rate ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Hyaline Membrane Disease ◽  
Supplemental Oxygen ◽  
Pulmonary Insufficiency ◽  
Radiologic Findings ◽  
Sense Of Security ◽  
Hyaline Membrane ◽  
False Sense

This report describes a syndrome of delayed respiratory distress occurring in premature infants usually under 1,250 gm at birth. Unlike hyaline membrane disease, this syndrome occurs after four to seven days in a previously healthy infant; also unlike hyaline membrane disease, it persists for two to four weeks. Chronic pulmonary insufficiency of prematurity (CPIP) carries a 10% to 20% mortality rate. The infants are frequently apneic, require supplemental oxygen, but lack the radiologic findings of hyaline membrane disease or bronchopulmonary dysplasia. When compared with nondistressed infants of similar birthweight, infants with CPIP demonstrate slowly progressive atelectasis, hypoxemia, and hypercapnia. Recovery is usually complete by 60 days of age. The importance of CPIP is that an awareness of its existence can eliminate a false sense of security, often communicated to anxious parents, during the four-to-seven-day grace period before its appearance is clinically obvious. The physiologic similarities between CPIP and hyaline membrane disease suggest that lack of surfactant may play a role in the pathogenesis of CPIP.

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.

PREVENTION OF HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 513-514
Author(s):  
Mary Ellen Avery
Keyword(s):  
Respiratory Distress ◽  
Premature Infants ◽  
Statistical Significance ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

The articles by Liggins and Howie and Baden, et al. in this issue of Pediatrics are of great interest to perinatologists because they describe efforts to extend to premature infants results of recent studies on maturation of lungs of lambs and rabbits in the prevention of hyaline membrane disease. The two reports provide both promise and caution. When labor can be delayed at least 24 hours in infants under 32 weeks, infusion of betamethasone into the mother can prevent respiratory distress in the infant. Results in infants over 32 weeks' gestation suggest a positive benefit, but the number of infants in the series was too small to reach statistical significance.

THE RESPIRATORY DISTRESS SYNDROME AND ITS SIGNIFICANCE IN PREMATURE INFANTS

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 194-204
Author(s):  
William Allen Bauman
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Clinical Manifestations ◽  
Hyaline Membrane Disease ◽  
Respiratory Difficulty ◽  
Hyaline Membrane ◽  
Central Nervous Systems ◽  
Physical Findings

THE RESPIRATORY distress syndrome of the newborn period is recognized as a clinical entity predominantly afflicting newborn premature infants. Although disorders of the cardiovascular and central nervous systems as well as metabolic derangements are capable of causing a newborn infant to have dyspnea, in those who die the pathologist more frequently finds pulmonary disease. Microscopic examination of the premature infant's lung often discloses atelectasis, emphysema, edema, pneumonia, hemorrhage, aspiration of amniotic debris and the presence of hyaline membrane. In a previous study a significant relationship between respiratory difficulty in early life, pulmonary roentgenographic abnormalities, and the presence of pulmonary hyaline membrane at necropsy was demonstrated. Curtis has most recently reviewed much of the literature relating to etiology and treatment of "hyaline membrane disease." The clinical manifestations of the syndrome, however, have been infrequently recorded. Miller and Jennison in a survey of more than 4,000 births indicated that the infants who died with hyaline-like material in the lungs had had symptoms characterized by marked respiratory difficulty including retraction of the lower chest wall on inspiration. Parmelee stated that dyspnea was frequently associated with retractions of the rib margins and lower sternum and that there also was grunting and cyanosis to a varying degree. Blystad showed that 15 of 25 dyspneic newborn prematures who died had hyaline membrane formation in the lungs. It is the purpose of this paper to present a clinical appraisal of the respiratory distress syndrome and further to demonstrate its relationship to the presence of pulmonary hyaline membrane at necropsy. CLINICAL DIAGNOSIS The newborn premature infant may manifest the respiratory distress syndrome by several physical findings. Characteristically he breathes as if he has glottic obstruction; intercostal retractions accompany strong inspiratory movements.

Surfactant for Hyaline Membrane Disease

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 795-798 ◽  
Author(s):  
Tetsuro Fujiwara ◽  
Forrest H. Adams
Keyword(s):  
Premature Infants ◽  
Lung Surfactant ◽  
Hyaline Membrane Disease ◽  
The Other ◽  
Synthetic Surfactant ◽  
Natural Surfactant ◽  
Hyaline Membrane ◽  
Dipalmitoyl Lecithin ◽  
Air Intake ◽  
Relative Deficiency

Since it has been demonstrated that hyaline membrane disease (HMD) is due to a relative deficiency of lung surfactant,1,2 one possible approach to the treatment or prevention of HMD in premature infants might be the introduction of surfactant into the lungs. Thus far, attempts at aerosolization of either synthetic surfactant (dipalmitoyl lecithin [DPL]) or natural surfactant into the lungs of patients or animals have failed to produce convincing benefits.3-5 On the other hand, direct instillation of a solution of natural surfactant into the trachea seems to produce striking results. Enhörning et al6 were the first to show that tracheal deposition of natural surfactant into premature rabbit fetuses before the first breath enhanced air intake and improved the pressure-volume relationships of the lungs; it also increased their survival time.7

scholarly journals Neonatal outcome in new-borns admitted in NICU of tertiary care hospital in central India: a 5-year study

2018 ◽  
Vol 5 (4) ◽  
pp. 1364 ◽  
Author(s):  
Jyotsna Verma ◽  
Shweta Anand ◽  
Nawal Kapoor ◽  
Sharad Gedam ◽  
Umesh Patel
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Distress Syndrome ◽  
Perinatal Asphyxia ◽  
Hyaline Membrane Disease ◽  
Low Birth Weight Babies ◽  
Hyaline Membrane

Background: Neonatal mortality rate contributes significantly to under five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute and help in managing resources, infrastructure, skilled hands for better outcome in future.Methods: This retrospective study was done on 1424 neonates who were admitted at LN Medical College and JK Hospital, Bhopal in neonatal intensive care unit (NICU) in the Department of Paediatrics from January 2013-December 2017.Results: 1424 newborns admitted within 24 hours of birth were included in the study. About 767 were male neonates, (Male: female1.16:1). The low birth weight babies were 54% in our study. Among the various causes of NICU admission, Respiratory distress was present in 555 (39%) of neonates, Respiratory distress syndrome (Hyaline membrane disease) being the most common cause of respiratory distress. Neonatal sepsis accounted for morbidity in 24% of neonates, with Klebsiella being the most common organism grown in the blood culture. The incidence of congenital anomalies was 2.5%. The neonatal mortality was found to be 11% in our study. Prematurity with Respiratory distress syndrome (Hyaline membrane disease) and perinatal asphyxia were the two most common causes of neonatal mortality in the study. Extremely low birth weight neonates had the highest case fatality rate in the study, which indicates the need to develop an efficient group of professionals in teaching hospitals who will provide highly specialized and focused care to this cohort of vulnerable neonates.Conclusions: Present study has shown respiratory distress, perinatal asphyxia, and sepsis as the predominant causes of neonatal morbidity. All three are preventable causes, and our health-care programs should be directed toward addressing the risk factors in the community responsible for the development of these three morbidities. The preterm and low birth weight babies had significantly high mortality even with standard intensive care; therefore, a strong and effective antenatal program with extensive coverage of all pregnant females specifically in outreach areas should be developed which will help in decreasing preterm deliveries and also lower the incidence of low birth weight babies.

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.

A Ten-Year Retrospective Study of Pink and Yellow Neonatal Hyaline Membrane Disease

PEDIATRICS ◽  
1983 ◽  
Vol 72 (2) ◽  
pp. 170-175
Author(s):  
Susan Beckwitt Turkel ◽  
John R. Mapp
Keyword(s):  
Retrospective Study ◽  
Premature Infants ◽  
Hyaline Membrane Disease ◽  
Bilirubin Encephalopathy ◽  
Hyaline Membranes ◽  
Hyaline Membrane ◽  
Frequent Finding ◽  
Brain Correlates ◽  
Bilirubin Toxicity ◽  
The Brain

Since it was first described several years ago, yellow bilirubin staining of the pulmonary membranes in neonatal hyaline membrane disease has apparently become more common. In a retrospective study of neonatal autopsy experience, it was found that as more of the premature infants survived longer, yellow hyaline membrane disease was a more frequent finding, increasing from 7% of all newborns having hyaline membrane disease at autopsy in 1970 to 50% in 1980. In comparing 499 cases with eosinophilic hyaline membranes with 168 cases of yellow membranes, newborns with bilirubin staining of the pulmonary membranes were found to be more premature (P &lt; .02), had smaller autopsy weight (P &lt; .002), and survived longer (P &lt; .00001). When multiple clinical parameters were compared between a group of infants with yellow membranes and a group of infants with pink membranes who were matched for gestational age, year of birth, and length of survival, no differences were found between the two groups. No correlation was found between kernicterus and yellow staining of the pulmonary hyaline membranes in the first years of the study, but there was a strong correlation in the last 5 years, coincident with the increase in the rate of yellow hyaline membrane disease found at autopsy. The gross bilirubin staining of the brain was the secondary type of kernicterus, not toxic bilirubin encephalopathy. The observation of bilirubin staining in the lung and in the brain correlates with prolonged survival in some very small premature infants. This does not appear to be a manifestation of bilirubin toxicity, but rather a marker of prior tissue damage.

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