PEDIATRICS Vol. 21 No. 5 May 1958, pp. 813-824
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CHEST RADIOGRAPHY OF PREMATURES

A Planned Study of 104 Patients Including Clinico-pathologic Correlation of the Respiratory Distress Syndrome

William Allen Bauman M.D.1 and Jerome Nadelhaft M.D.1

1 Departments of Pediatrics and Radiology, College of Physicians and Surgeons, Columbia University, and Babies Hospital, New York

The chests of 104 unselected, newborn prematures were studied by roentgenogram in the first 72 hours of life in a routine manner which yielded satisfactory roentgenograms and involved minimal disturbance of the patients. Nineteen of the infants showed clinical signs of dyspnea sufficient to suggest that they were suffering from some degree of the respiratory distress syndrome. Thirty-five of the total number presented roentgenographic pictures compatible with hyaline membrane syndrome. Twenty-five of the infants died within the first 8 days of life. Of the 23 in this fatal group who came to necropsy, 10 had hyaline membranes: Eight of these had shown during life both respiratory distress and pulmonary roentgenographic appearance of bilateral diffuse increased reticulogranularity. In statistical analyses, this association is found to be highly significant (p < 0.006).

That several infants with both these abnormalities survived indicates that prematures may recover from the respiratory distress syndrome. Until the diagnosis can be established with greater certainty during life, the possibility of spontaneous recovery must be considered in the evaluation of therapeutic measures.

In the individual case, a premature who has a high retraction score and pulmonary roentgenograms demonstrating increased reticulogranularity has a greater chance of dying with hyaline membrane formation than does the infant who fails to show these symptoms and signs during life.

Submitted on December 2, 1957
Accepted on December 19, 1957