PEDIATRICS Vol. 41 No. 3 March 1968, pp. 549-559
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THE SIGNIFICANCE OF GRUNTING IN HYALINE MEMBRANE DISEASE

V. C. Harrison M.B.Ch.B., M.Med.1, H. de V. Heese M.D., M.R.C.P.E.1, and M. Klein M.B., Ch.B.1

1 Neonatal Respiratory Unit, Groote Schuur Hospital and Department of Child Health, University of Cape Town, South Africa

Grunting was investigated in 22 infants with hyaline membrane disease. It was demonstrated to be a modified Valsalva maneuver, as during expiration intrapleural pressure was increased by closure of the glottis and contraction of the abdominal muscles. Grunting could be prevented if the trachea was intubated; but, during this period the arterial oxygen tension fell. After detubation grunting recommenced and arterial oxygen tension rose to previous levels. Therefore, grunting appears to be a protective form of breathing, aimed at raising the PaO2. This is probably achieved by improvement of alveolar ventilation, but the exact mechanism is not known.

Submitted on April 10, 1967
Accepted on October 2, 1967




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