HYALINE MEMBRANE DISEASE(HMD)

1. Absence of surfactant -> high surface tension -> tendency to become atelectatic 2. major constituents of surfactant ; dipalmitylphosphatidylcholine(lecithin), phosphatidyl glycerol, apoproteins(SP-A,B,C) 3. factors supressing surfactant synthesis ; asphyxia, hypoxemia, pulmonary ischemia, hypovolemia, hypotension, cold stress III. PATHOLOGY 생후 6-8hr 이전에는 특징적인 소견 나타나지 않음 1. grossly - deep purplish red and liver like in consistency 2. microscopically - alveolar duct, alveoli and bronchiole -> lined with acidophylic, homogenous, or granular membrane IV. CLINICAL MANIFESTATION - tachypnea, prominent grunting, intercostal and subcostal retraction, nasal flaring, duskiness, cyanosis(unresponsive to oxygen therapy) -> progressive worsening cyanosis & dyspnea, apnea, irregular respiration, mixed respiratory and metabolic acidosis, edema, ileus, oliguria - Improvement is heralded by a spontaneous diuresis and the ability to oxygenate the infant with lowe…
…