Lung Function at Birth in Babies Developing Respiratory Distress

Summary Gaseous exchange and total compliance of the chest wall and lung were measured during and after positive pressure ventilation in infants requiring resuscitation at birth. Thirteen infants later developed fatal idiopathic respiratory distress syndrome of the newborn and had hyaline membranes in their lungs at autopsy, Respiratory function in these infants was compared with that observed in 12 infants of short gestation who also required resuscitation at birth but who did not subsequently develop respiratory distress. Pathological changes appeared to be present at the time of delivery in the lungs of at least 9 of the 13 infants who died with hyaline membrane disease; the lungs and chest were abnormally stiff and the lungs did not appear to form a residual volume during resuscitation. These results are compared with the findings in a small group of infants who developed respiratory difficulty after birth because of lung hypoplasia (2 cases), massive aspiration during delivery (3 cases), and intracranial haemorrhage (4 cases).