Hyaline Membrane Disease (Respiratory Distress Syndrome) (HMD) (RDS

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SYNDROME</B></U></A></div> <div> <A HREF="id28.htm" TARGET="_top" TITLE="NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)"><U><B>NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)</B></U></A></div> <div> <B>Hyaline Membrane Disease (Respiratory Distress Syndrome) (HMD) (RDS</B></div> <div> <A HREF="id30.htm" TARGET="_top" TITLE="infectious disease"><U><B>infectious disease</B></U></A></div> <div> <A HREF="id32.htm" TARGET="_top" TITLE="HEMORRHAGIC DISEASE IN A NEW BORN"><U><B>HEMORRHAGIC DISEASE IN A NEW BORN</B></U></A></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="OPTIC NERVE GLIOMA"><U><B>OPTIC NERVE GLIOMA</B></U></A></div> <div> <A HREF="id36.htm" TARGET="_top" TITLE="New Born Assessment "><U><B>New Born Assessment </B></U></A></div> <div> <A HREF="id38.htm" TARGET="_top" TITLE="laryngomalacia"><U><B>laryngomalacia</B></U></A></div> <div> <A HREF="id39.htm" TARGET="_top" TITLE="CRANIOSYNOSTOSIS "><U><B>CRANIOSYNOSTOSIS </B></U></A></div> <div> <A HREF="id40.htm" TARGET="_top" TITLE="DANDYWALKER MALFORMATION "><U><B>DANDY-WALKER MALFORMATION </B></U></A></div> <div> <A HREF="id41.htm" TARGET="_top" TITLE="DEJERINESOTTAS DISEASE "><U><B>DEJERINE-SOTTAS DISEASE </B></U></A></div> <div> <A HREF="id42.htm" TARGET="_top" TITLE="DOWN SYNDROME "><U><B>DOWN SYNDROME </B></U></A></div> <div> <A HREF="id43.htm" TARGET="_top" TITLE="Respiratory Syncytial Virus (RSV)"><U><B>Respiratory Syncytial Virus (RSV)</B></U></A></div> <div> <A HREF="id44.htm" TARGET="_top" TITLE="FABRY DISEASE "><U><B>FABRY DISEASE </B></U></A></div> <div> <A HREF="id45.htm" TARGET="_top" TITLE="PRADERWILLI SYNDROME "><U><B>PRADER-WILLI SYNDROME </B></U></A></div> <div> <A HREF="id37.htm" TARGET="_top" TITLE="new born fun"><U><B>new born fun</B></U></A></div> <div> <A HREF="id46.htm" TARGET="_top" TITLE="RETT SYNDROME "><U><B>RETT SYNDROME </B></U></A></div> <div> <A HREF="id47.htm" TARGET="_top" TITLE="Alexander Disease"><U><B>Alexander Disease</B></U></A></div> <div> <A HREF="id49.htm" TARGET="_top" TITLE="leukemia"><U><B>leukemia</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Contact Me"><U><B>Contact Me</B></U></A></div> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> Hyaline Membrane Disease (Respiratory Distress Syndrome) (HMD) (RDS</div> <div> <B>Clinical Presentation:</B></div> <div> Preterm infants with respiratory distress. </div> <div> <B>Etiology/Pathophysiology:</B></div> <div> Preterm infants have pulmonary immaturity which results in a surfactant deficiency. Surfactant lowers the surface tension of the alveolar membrane. Without surfactant the alveoli collapse at the end of each expiration. This in turn leads to respiratory failure in the neonate. In older infants surfactant deficiency can arise when they develop asphyxia/shock and acidosis.</div> <div> <B>Pathology:</B></div> <div> Generalized capillary leak and mucosal necrosis leads to the small air filled terminal airways, the respiratory bronchioles and alveolar ducts, being surrounded by collapsed alveoli filled with debris in a near uniform distribution, and this leads to the classic "ground glass" appearance on the chest x-ray. </div> <div> <B>Imaging Findings:</B></div> <div> Radiographic changes usually appear shortly after birth, but can be delayed for 12-24 hours. The classic "ground glass" appearance consists of a bilaterally symmetrical homogeneously stippled pattern of fine lucencies (air bronchograms) interspersed with linear densities that causes the heart and diaphragm contours to become obscured. The patient usually has a decreased lung volume, and vertically oriented ribs leading to a bell shaped thorax. The classical symmetrical appearance will most probably not be present in patients who have received artificial surfactant therapy.</div> <div> <B>DDX:</B></div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Meconium Aspiration - usually has nodular non homogeneous densities, may have pleural effusions, usually has an increased lung volume. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Neonatal pneumonia - usually has non homogeneous densities, may have pleural fluid, usually has a normal lung volume. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Transient Tachypnea of the Newborn - usually has non homogeneous densities, may have pleural fluid. </div> <div> <IMG SRC="09c09e80.jpg" border=0 width="265" height="232" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Supine chest radiograph demonstrates a bell shaped thorax with diffuse and symmetrical ground glass infiltrates</div> <div> <IMG SRC="09e49100.jpg" border=0 width="329" height="272" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Supine chest radiograph demonstrates diffuse and symmetrical ground glass infiltrates</div> <div> <IMG SRC="0a025c40.jpg" border=0 width="293" height="196" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Supine chest radiograph from day one of life demonstrates bilateral, irregular coarse infiltrates</div> <div> meconium aspiration</div> <div> <IMG SRC="0a1ebbd0.jpg" border=0 width="235" height="189" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Supine chest radiograph at five hours of life demonstrates diffuse bilateral granular infiltrates</div> <div> Pneumonia, Neonatal (Group B Streptococcus)</div> <div> <IMG SRC="0a2ebc10.jpg" border=0 width="235" height="193" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"><IMG SRC="0a3ebc50.jpg" border=0 width="235" height="197" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">Supine chest radiograph of a newborn demonstrating mild cardiomegaly and bilateral reticulonodular densities that radiate from the hila. There is atelectasis in the upper lobes.</div> <div> Supine chest radiograph in the same patient taken one day later showing interval clearance of the reticulonodular densities</div> <bR> </td> </tr></table></body>