Radiological analysis of hyaline membrane disease after exogenous surfactant treatment.
BACKGROUND
Exogenous surfactant treatment of hyaline membrane disease is known to modify the pattern of radiological changes on the chest radiograph.


OBJECTIVE
To analyse and attempt to explain the radiological changes observed after exogenous surfactant treatment. Materials and methods. Thirty-nine premature infants with typical hyaline membrane disease.


RESULTS
Transient asymmetrical clearing with better aeration of the right lung in the absence of malposition of the tip of the endotracheal tube was observed in nine cases (23 %). This asymmetry was patchy in one case. It was due to a complication of mechanical ventilation in three cases [pneumothorax (n = 2) and pneumomediastinum (n = 1)]. In the other six cases, asymmetrical clearing could be related to the anatomical position of the right main bronchus, which facilitates distribution of surfactant to the right lung. However, the course of these premature infants was similar to that of infants with symmetrical chest radiological findings after treatment.


CONCLUSIONS
Asymmetrical clearing of chest radiographs, sometimes patchy, after surfactant treatment requires exclusion of pneumothorax or infection but has no influence on clinical outcome.
Slama
M
M
Service de Radiologie, Hôpital Saint Vincent de Paul, 74-82 Avenue Denfert Rochereau, F-75 014 Paris, France.
André
C
C
Huon
C
C
Antoun
H
H
Adamsbaum
C
C
D001688:Biological Products; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006819:Hyaline Membrane Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D007231:Infant, Newborn; D007322:Instillation, Drug; D008297:Male; D010743:Phospholipids; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D016896:Treatment Outcome
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; C068291:poractant alfa