Adult respiratory distress syndrome in full term neonates.
From July 1987 to October 1991, we experienced 10 full-term newborn infants with severe adult respiratory distress syndrome (ARDS). The triggering events were intrauterine/perinatal asphyxia in 6 and sepsis in 4. All had severe respiratory distress/failure and were mechanically ventilated with high concentration of inspired oxygen and positive end-expiratory pressure. Radiography of the chest all showed bilateral dense consolidation (white out lungs) and reduced lung volume. Persistent pulmonary hypertension (PPHN) was documented in 9 cases (90%). The concomittent occurrence of ARDS and PPHN rendered respiratory management extremely difficult. High-rate ventilation and tolazoline infusion were used in all these 9 PPHN cases. Acute complication of respiratory therapy (pneumothorax) was encountered in 5 patients. Only 3 cases survived, all belonging to the asphyxia group. Of these 3 survivors, 1 developed bronchopulmonary dysplasia, 1 had cerebral palsy on follow up and the other one was lost on follow up. The outcome of neonatal ARDS was generally poor.
Hung
H Y
HY
Department of Pediatrics, Mackay Memorial Hospital Taipei, Taiwan, R.O.C.
Huang
F Y
FY
Ho
M Y
MY
Kao
H A
HA
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011175:Positive-Pressure Respiration; D011379:Prognosis; D013902:Radiography, Thoracic; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000628:therapy