Patterns of evolution of X-ray changes in respiratory distress syndrome.

In a review of all infants admitted to our hospital with hyaline membrane disease during a recent period, we observed that two distinct groups developed complete pulmonary opacification during the course of their disease. One group (9% of the total) developed a classic "white-out" of stage II bronchopulmonary dysplasia early in the course of their disease while critically ill. The prognosis for this group was poor. The other group (10% of the total) developed an almost identical radiographic finding later in the course of their disease as they were clinically improving and being weaned from the respirator. In this group the "white-out" was transient and not related to clinical deterioration; rather, it was secondary to decreased ventilatory pressures. The prognosis for this group was quite good.