LearningRadiology.com - Hyaline Membrane disease,respiratory distress syndrome,newborn,tachynea,RSD,HMD

Hyaline Membrane Disease

Respiratory Distress Syndrome (of the Newborn)

Acute pulmonary disorder of the newborn characterized by
- Generalized atelectasis
- Intrapulmonary shunting
- Ventilation-perfusion abnormalities
- Reduced lung compliance
M:F =1.8:1
Cause
- Immature surfactant production (usually begins at 18-20 weeks of gestational age)
  - Causes acinar atelectasis
Predispositions
- Premature infants
- Cesarean section
- Infants of diabetic mothers
- Perinatal asphyxia
Clinical findings
- Onset
  - Usually less than 2-5 hours after birth
  - Increases in severity from 24 to 48 hours
  - Then, gradual improvement after 48-72 hours
- Abnormal retraction of chest wall
- Cyanosis
- Expiratory grunting
- Increased respiratory rate
Imaging findings
- Typically, diffuse “ground-glass” opacification of both lungs with air bronchograms and hypoaeration
- Hypoaeration from loss of lung volume (may be counteracted by respiratory therapy)
- Fine granular pattern
- Prominent air bronchograms
- Bilateral and symmetrical distribution
Prognosis
- Spontaneous clearing within 7-10 days (mild course in untreated survivors)
- Death in 18%
Acute complications
- Barotrauma may produce
  - Parenchymal pseudocyst
  - Pulmonary interstitial emphysema
    - Pseudoclearing
      - Lungs appear less because of innumerable small pockets of air in the peribronchial interstitial spaces
  - Pneumomediastinum
  - Pneumothorax

Diffuse ground-glass appearance to both lungs with a left-sided
tension pneumothorax and pneumomediastinum
(orogastric tube is in distal esophagus)

Dahnert 4^th edition