Kitterman J A
Cardiovascular Research Institute, University of California, San Francisco 94143.
J Pediatr. 1993 Dec;123(6):969-74. doi: 10.1016/s0022-3476(05)80396-8.
Three preterm infants are described who had respiratory failure immediately after birth. For each, historical factors (extrauterine abdominal pregnancy; ruptured membranes with oligohydramnios for 14 weeks; congenital diaphragmatic hernia) and the initial postnatal course were suggestive of pulmonary hypoplasia. However, with vigorous resuscitation each infant showed rapid improvement in pulmonary status for several hours. Two infants survived with no apparent pulmonary sequelae; the third had almost complete resolution of pulmonary disease but died from gastrointestinal complications. Thus some infants with historical and clinical indicators of severe pulmonary hypoplasia do not have hypoplastic lungs and respond favorably to resuscitation. The causes of the respiratory distress and of its rapid resolution are not known. On the basis of this experience, even infants with historical factors suggesting pulmonary hypoplasia and with postnatal respiratory distress should receive vigorous resuscitation.
本文描述了三名早产婴儿，他们出生后立即出现呼吸衰竭。对于每一名婴儿，病史因素（宫外腹腔妊娠；胎膜破裂伴羊水过少14周；先天性膈疝）以及出生后的初始病程提示存在肺发育不全。然而，经过积极复苏，每名婴儿的肺部状况在数小时内都迅速改善。两名婴儿存活，无明显肺部后遗症；第三名婴儿肺部疾病几乎完全消退，但死于胃肠道并发症。因此，一些具有严重肺发育不全病史和临床指标的婴儿并没有发育不全的肺，且对复苏反应良好。呼吸窘迫及其迅速缓解的原因尚不清楚。基于这一经验，即使是具有提示肺发育不全病史因素且出生后出现呼吸窘迫的婴儿，也应接受积极复苏。
