Hyaline membrane disease: The Daily PANCE Blueprint

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Hyaline membrane disease: The Daily PANCE Blueprint

A few hours after delivery, a 3lb 14oz female newborn develops respiratory distress. She was born at 32 weeks gestation. She is tachypneic (RR 62 breaths/min). On physical exam, she has nasal flaring, cyanosis, and expiratory grunting. CXR demonstrates low lung volumes and atelectasis. Which of the following most likely is causing her symptoms and condition?

A. Congenital diaphragmatic hernia
B. Increased pulmonary vasculature resistance
C. Decreased in surfactant
D. Pulmonary stenosis and RV failure
E. Aspiration of meconium

Answer and topic summary

The answer is C. Decreased in surfactant

Hyaline membrane disease or respiratory distress syndrome (RDS) is a lung disorder in infants that is specifically due to the lack of pulmonary surfactant in an immature lung. The most important risk factor is premature birth (the risk increases with decreasing gestational age). Other risk factors include maternal diabetes, cesarean delivery, etc. Clinical features include tachypnea, expiratory grunting, nasal flaring, retractions, cyanosis, and decreased breath sounds; it usually occurs immediately after birth. CXR may show bilateral opacities, atelectasis, and low lung volumes. Treatment includes antenatal corticosteroid therapy, intubation or positive airway pressure (e.g., NIPPV or nasal CPAP), and surfactant therapy.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Pulmonary ⇒ Other Pulmonary Disease ⇒ Hyaline membrane disease

Also covered as part of the Pediatric Rotation topic list

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