Losa M, Kind C
Intensivstation, Ostschweizer Kinderspital, St. Gallen, Switzerland.
Eur J Pediatr. 1998 Nov;157(11):935-8. doi: 10.1007/s004310050971.
We observed a premature baby born after severe oligohydramnios who could not be ventilated efficiently even with very high pressures immediately after birth, but who, after cessation of resuscitation attempts, recovered spontaneous sufficient breathing during the following hour. After this experience we searched our case records for other newborns with dry lung syndrome using the following definition: (1) premature birth after prolonged leakage of amniotic fluid, (2) very high ventilatory requirement after birth, (3) dramatic improvement during the first 24 to 36 h and (4) respiratory distress syndrome and infection excluded. Among 93 prematures with rupture of membranes for 4 days or more we found 3, including the index case, matching this definition.
Dry lung syndrome appears to be a distinct clinical entity that is possibly underrecognised but recognisable and that merits further study. Its pathogenesis may imply complete collapse of small airways to a degree that capillary forces impede distension by ordinary ventilatory pressures.
我们观察到一名严重羊水过少后出生的早产儿，出生后即便使用很高的压力也无法有效通气，但在停止复苏尝试后，在接下来的一小时内恢复了自主充足呼吸。有了这次经历后，我们在病例记录中查找其他符合以下定义的干性肺综合征新生儿：（1）羊水长时间渗漏后早产；（2）出生后通气需求极高；（3）在最初24至36小时内显著改善；（4）排除呼吸窘迫综合征和感染。在93例胎膜破裂4天或更长时间的早产儿中，我们发现3例符合该定义，包括索引病例。
干性肺综合征似乎是一种独特的临床实体，可能未得到充分认识，但可被识别，值得进一步研究。其发病机制可能意味着小气道完全塌陷到一定程度，以至于毛细血管力阻碍了普通通气压力下的扩张。
