937 SEGMENTAL RETICULOGRANULAR LUNG DISEASE IN INFANTS OF DIABETIC MOTHERS (IDM)

Abstract

A new pulmonary disease distinct from either respiratory distress syndrome (RDS), transient tachypnea of the newborn, or RDS type II, has been studied in 7 infants of diabetic mothers (IDM). Both standard A-P and lateral, and magnification (mag.) chest x-rays revealed a segmentally distributed coarse reticulogranular pattern and increased lung volumes but no significant increase in perihilar bronchovascular markings or thickened fissures. All mothers were insulin dependent and 6/7 had C-sections. Clinical profile of patients (means): wt. 3.1 kg., gestational age 37 wks., mechanical ventilation 2/7, CPAP 4/7. All patients survived and most were in FiO2 ≥ .25 by day 6. 3 pts. had pulmonary function tests on day 3: Mean compliance 3.2 ml/cm H2O. Mean insp. and exp. lung resist. were 32 and 30 cm H2O/L/sec. respectively. Funct. residual cap. was low in 2 pts. (mean 17 ml/kg) and normal in 1 pt. (38 ml/kg). A new clinical syndrome in large IDM's is described. It is characterized by a mild clinical course (hypercapnia, tachypnea, and hypoxemia) and a segmental coarse reticulogranular lung infiltrate confirmed by mag. chest radiographs. Although x-rays showed increased lung volumes, 2 pts. had decreased FRC.