M. Paetzel (Cleveland/USA)  

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Newborn  

N/A  

Thorax-Lung  

congenital  

The images shown here were obtained from various premature infants of the 25th-29th gestational week. Postpartally, a respiratory deficiency was noted (moaning). Sometimes a retraction was seen. In the fourth case, cyanosis was noted initially.  

IRDS (idiopathic respiratory distress syndrome. Earlier: Hyaline-Membrane Syndrome) is based on underdeveloped pulmonary surfactant production. The deficiency of the mainly pospholipid surfactant leads to a collapse of the alveoles, which leads to atelectasic ventilation.

Also, through the course of the disease, there is an excretion of underdeveloped proteins seen, which deposit themselves in a membrane-like manner (Therefore the old name "hyaline membranes"). This stage is through early treatment now rarely seen.  

<- view X-Ray 1

X-Ray 1: Stage 1: slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings. (The matches are used to show size)




<- view X-Ray 2

X-Ray 2: Stage 2: Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)




<- view X-Ray 3

X-Ray 3: Stage 3: like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.




<- view X-Ray 4

X-Ray 4: Stage 4: White lung: practically homogenic lung opacity.




<- view X-Ray 5

X-Ray 5: Synopsis of the changes in Stages I - IV.

 

Expert's opinion  

Alveolar respiratory deficiency, wet lung, infection, ARDS (also in newborns, i.e. after infection or blood transfusion), pleural effusion of both sides, pulmonary edema.  

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IRDS, premature infant, surfactant deficiency, infantile respiratory distress syndrome, ARDS, child, childhood, pediatric radiology  

M Paetzel. Respiratory distress syndrome (grade 1-4) of the premature and newborn (IRDS). PedRad [serial online] vol 2, no. 11.
URL: www.PedRad.info/?search=20021110223558