Pulmonary epithelial permeability in hyaline-membrane disease

Journal Article · Thu Oct 25 00:00:00 EDT 1984 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198410253111703· OSTI ID:5926391

Jefferies, A L; Coates, G; O'Brodovich, H

Neonatal hyaline-membrane disease is complicated by pulmonary edema, yet left atrial pressures are normal. Alveolar-capillary-membrane permeability may therefore be increased. To assess pulmonary epithelial permeability, we measured the pulmonary clearance and half-life of aerosolized /sup 99m/Tc-diethylenetriamine pentacetate (/sup 99m/Tc-DTPA) on 31 occasions in 15 intubated premature infants with hyaline-membrane disease. Three infants with respiratory failure due to other diseases were studied on four occasions. All studies of infants with hyaline-membrane disease that were performed in the first 72 hours of life demonstrated a biphasic clearance curve with a rapid-phase half-life of 1.6 +/- 0.6 minutes (mean +/- S.D.). As these infants recovered, the curve became monophasic with a half-life of 56.0 +/- 32.1 minutes. Two infants remained dependent on oxygen and ventilator support and had persistent biphasic curves with a rapid-phase half-life of 1.5 +/- 0.7 minutes. All infants without hyaline-membrane disease had monophasic curves with a half-life of 65.4 +/- 33.6 minutes. Using a similar technique, we observed that newborn lambs and piglets have a monophasic pulmonary clearance of /sup 99m/Tc-DTPA (114 +/- 59 minutes in lambs and 52.5 +/- 16.3 minutes in piglets). We conclude that the lungs of neonates with hyaline-membrane disease are abnormally permeable to small solutes and that this abnormality persists in infants with subsequent chronic lung disease.

• Research Organization: McMaster Univ. Health Sciences Centre, Hamilton, Ontario
• OSTI ID: 5926391
• Journal Information: N.Engl. J. Med.; (United States), Vol. 311:17
• Country of Publication: United States
• Language: English

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