Pulmonary and respiratory function changes in survivors of hyaline-membrane disease.

With the possibility existing that survivors of the respiratory-distress syndrome of the newborn may have lung changes secondary to therapy, chest roentgenograms, PaO, and A-a oxygen gradients in 12 selected patients who survived hyaline-membrane disease were observed and measured. Three of four infant survivors had abnormal chest roentgenograms for as long as two years. Abnormally large A-a gradients present at birth became normal by nine months. Five of eight long-term survivors had abnormal chest roentgenograms. This group as a whole had an abnormally low PaO, and an increased A 4 oxygen gradient. Eight of 14 children born prematurely and who developed retrolental fibroplasia secondary to prolonged oxygen therapy but who had no history of respiratory distress had abnormal chest roentgenograms similar to survivors of hyaline-membrane disease. These similarities suggest that abnormally high inspired oxygen tensions (> 280 mm Hg) cause the long-term changes seen by us in survivors of hyalinemembrane disease.