View source for Hyaline Membrane Disease (syn RDS) and BPD

<div class="WPC-editableContent"><font size="4"><b>Introduction</b></font><br/><blockquote>Respiratory Distress Syndrome (RDS) has historically been the chief cause of respiratory failure in premature infants. The same condition is known as Hyaline Membrane Disease (HMD). RDS is due to an inadequate amount of surfactant, a substance produced by the lungs which stabilizes the tiny air sacs in the lungs. In normal lungs at the end of exhalation, a small amount of residual gas remains in the alveoli. Without surfactant, these alveoli fully deflate at the end of each exhalation, and are difficult to reopen in order to fill with air during the next breath. The diminished amount of air-filled alveoli in the lung causes the lung fields to appear dense. However, there may be air in the conducting airways, which are surrounded by the atelectatic alveoli. This relationship between air in the airways surrounded by atelectatic alveoli causes the airways to appear as black branching lines known as "air bronchograms" <a class="external" href="http://www.uen.org/utahlink/tours/tourElement.cgi?element_id=28357&amp;tour_id=15478&amp;category_id=24288" rel="nofollow" target="_blank">Source</a><br/><br/></blockquote><font size="4"><b><br/>X-ray Appearance<br/></b></font><ul><li class="MsoNormal"><font size="3">Typically, diffuse “ground-glass” or finely       granular appearance</font></li><li class="MsoNormal"><font size="3">Bilateral and symmetrical distribution</font></li><li class="MsoNormal"><font size="3">Air bronchograms are common</font></li><ul><li class="MsoNormal"><font size="3">Especially extending peripherally</font></li></ul><li class="MsoNormal"><font size="3"><u>Hypoaeration </u>in non-ventilated lungs</font></li><ul><li class="MsoNormal"><font size="3">Hyperinflation excludes HMD</font></li></ul><li class="MsoNormal"><font size="3">“Granularity” is the interplay of</font></li><ul><li class="MsoNormal"><font size="3">Air-distended bronchioles &amp; ducts</font></li><li class="MsoNormal"><font size="3">Background of atelectasis of alveoli</font></li></ul><li class="MsoNormal"><font size="3">May change from film-to-film if there is</font></li><ul><li class="MsoNormal"><font size="3">Expiration (air disappears)</font></li><li class="MsoNormal"><font size="3">Better aeration (small bubble formation)</font></li></ul></ul><a class="external" href="http://www.learningradiology.com/archives2008/COW+292-TTN/ttnccorrect.html" rel="nofollow" target="_blank">source http://www.learningradiology.com/archives2008/COW%20292-TTN/ttnccorrect.html</a><br/><font size="4"><b><br/></b></font><br/><font size="4"><b>Respiratory Distress Syndrome (RDS) AKA Hyaline Membrane Disease (HMD)</b></font><br/><blockquote><table align="bottom" cellpadding="3" class="WPC-edit-style-grid1 WPC-edit-border-all WPC-edit-styleData-color1=%23ebebeb&amp;color2=%23c7c7c7" width="100%"><tr><td class="" width="50%">[[File:XA2v8P39ucsOBVzkSIKfMw111770.jpeg|500px|RDS]]</td><td class="" width="50%"><font size="3">[[File:0034hxAj8spI6zISPXWfBQ136422.jpeg|500px|NEAR NORMAL cxr]]<br/></font></td></tr><tr><td class="" width="50%"><font size="3">This a typical RDS/HMD appearance on day 1. Note the following<br/><br/></font><ul><li><font size="3">diffuse granuloreticular pattern</font></li><li><font size="3">airbronchogram lines</font></li></ul>Compare this with the chest X-ray on the right which is 'near normal'</td><td class="" width="50%">This is a normalish chest image on a newborn. Note the following<br/><br/><ul><li>lungs are clearly significantly darker than mediastinum</li><li>no airbronchogram lines</li><li>no confluent airspace opacity<br/></li></ul></td></tr></table></blockquote><br/><br/><br/><font size="4"><b>Bronchopulmonary Dysplasia</b></font><br/> <blockquote> <table align="bottom" cellpadding="3" class="WPC-edit-style-grid1 WPC-edit-border-all WPC-edit-styleData-color1=%23ebebeb&amp;color2=%23c7c7c7" width="100%"> <tr><td class="" width="50%">[[File:B5iJTAwws5cQJ NbsOBf8w111143.jpeg|500px|bpd b]]</td><td class="" width="50%"><font size="3">Same baby as above on day 28<br/><br/>Now showing signs of BPD B<br/><br/></font></td></tr> </table> </blockquote> <br/><br/> <font size="4">Respiratory Distress Syndrome (RDS syn HMD) and Pulmonary Interstitial Oedema (PIE)</font><br/><blockquote><table align="bottom" cellpadding="3" class="WPC-edit-style-grid1 WPC-edit-border-all WPC-edit-styleData-color1=%23ebebeb&amp;color2=%23c7c7c7" width="100%"><tr><td class="" width="50%">[[File:O8twpH6Yor-TxvGbk2vzGA116930.jpeg|500px|HMD RDS]]</td><td class="" width="50%">[[File:ZebM0kM-0qesMfKqsg0-mA125661.jpeg|500px|RDS PIE]]</td></tr><tr><td class="" width="50%">Day 1<br/>Confluent airspace opacity consistent with hyaline membrane disease</td><td class="" width="50%">Day 3<br/>Hyaline membrane disease with focal interstitial emphysema (PIE)</td></tr></table></blockquote><br/><br/></div>