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Sample text
At the University of Wisconsin Perinatal Center, patent ductus arteriosus occurred in approximately half the cases of severe neonatal respiratory distress in the early part of the last decade (56), while at the present time it is somewhat infrequent. The reasons for the changing incidence of complications are unclear, but in the case of the PDA, the differences might be attributable to changing practices in management of intravenous fluids with lower water loads being infused at the present time {47).
At times, persistent tachypnea alone may be the prevailing symptom in the early neonatal period; however, even these more mildly affected neonates will eventually show increased ventilatory effort with retractions, grunting, and "see-saw" excursions of the chest and abdomen (45a). The expiratory grunt is a nonspecific indication of neonatal pulmonary dysfunction and appears to improve oxygenation by rais ing end expiratory pressure. Because of the compliance of the newborn's chest 3 . Overview of Hyaline Membrane Disease 25 TABLE I Clinical Features of Hyaline Membrane Disease 1.
Appl. Physiol. 14, 909-913. 2. Avery, M. , and Mead, J. (1959). Surface properties in relation to atelectasis and hyaline membrane disease. Am. J. Dis. Child. 97, 517-523. 3. Avery, M. , and Fletcher, B. D. (1974). " Saunders, Philadelphia, Pennsylvania. 4. , and Torrance, R. W. (1960). The effects of tracheal pressure upon flow: pressure relations in the vascular bed of isolated lungs. J. Exp. Physiol. 45, 352-361. 5. Bryant, A. C , Mansell, A. , and Levison, H. (1977). Development of the mechanical properties of the respiratory system.
