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Residual Pulmonary Findings in Clinical Hyaline-Membrane Disease

1968; Massachusetts Medical Society; Volume: 279; Issue: 20 Linguagem: Inglês

10.1056/nejm196811142792001

1533-4406

Frank M. Shepard, Richard B. Johnston, Eugene C. Klatte, Henry Burko, Mildred T. Stahlman,

Congenital Diaphragmatic Hernia Studies

Seventy infants who had clinical hyaline-membrane disease as neonates were followed from two to five years with repeated physical examinations and x-ray films of the chest. Nineteen of them had such severe symptoms that they required mechanical ventilatory assistance for periods ranging from 17 to 116 hours. During the follow-up period six of the 19 had radiologic evidence suggestive of pulmonary fibrosis or overexpansion or both. Only two had clinical evidence of frequent infections and expiratory wheezing that failed to respond to bronchodilator therapy; lung biopsies in these two indicated patchy areas of peribronchial and alveolar fibrosis. Subsequently, both showed clinical improvement. The clinical, radiologic and pathologic sequelae that occurred in these infants surviving clinical hyaline-membrane disease appear to result from the reparative process of the lung to the perinatal insult that produces the original disease.