Hyaline membrane disease; preclinical roentgen diagnosis; a planned study.

Abstract

Neonatal respiratory disease remains one of the major causes of death, especially in the premature infant. In this group an estimated 10,000 to 20,000 deaths occur each year (4, 25, 29, 35). What is now called hyaline membrane disease of the newborn was first described in 1903 in Germany (16) and in 1923 in the United States (17). In spite of this, progress in establishing unequivocal pathogenesis, diagnosis, and treatment has been slow. With this in mind, we undertook a study to determine whether the diagnosis could be made before the development of clinical symptoms, thereby facilitating prompt treatment. Clinical and Pathologic Findings Infants with hyaline membrane disease are usually premature, delivered by section, or born of a diabetic mother. Their stage of development must be sufficiently advanced (1,000 or more grams weight; seven months of gestation) to permit normal pulmonary gas exchange (31). The condition occurs only in infants who breathe after birth, never in the stillborn (3, 4, 25, 35)....