Pulmonary hyaline membranes: a study of the infant disease and experimental hyaline membranes induced pharmacologically.

Resorption atelectasis with pulmonary hyaline membrane formation1is a leading cause of neonatal death in the United States. Both its cause and pathogenesis remain obscure. The syndrome chiefly affects premature infants in inverse proportion to their birth weight2; infants of diabetic mothers, often born prematurely,3and perhaps infants delivered by caesarean section, although the increased incidence in the last group has been recently questioned.4 Clinically, these babies demonstrate respiratory distress at5or shortly after birth, with development of rapid and difficult respirations associated with chest retraction, as well as cyanosis and apneic intervals. The systolic blood pressure may drop to shock levels in the first half hour of life.6Severely affected infants are reported to be in uncompensated acidosis, and the blood oxygen saturation may be low.5Auscultation reveals a progressively poorer air exchange, and the typical chest x-ray pattern is one of