+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Pulmonary pathology in surfactant-treated preterm infants with respiratory distress syndrome: an autopsy study



Pulmonary pathology in surfactant-treated preterm infants with respiratory distress syndrome: an autopsy study



Biology of the Neonate 70(1): 21-28



The present study examines the histological features of the lungs of neonates who died of respiratory distress syndrome or related complications after surfactant therapy. Our aim was to determine whether these lungs showed any unusual histological findings. Complete autopsies were performed 6-12 h after death in 10 surfactant-treated preterm infants and in 30 infants who died before surfactant therapy was available. Representative paraffin sections of all pulmonary lobes, stained with haematoxylin and eosin, were examined microscopically. A few selected slides were also stained with periodic acid-Schiff, Vierhoff-van Gieson, and Mallory trichrome. Hyaline membrane disease and bronchopulmonary dysplasia were present in each group, although there was an increased incidence of intra-alveolar haemorrhage in surfactant-treated babies (in 8 of 10 surfactant-treated as compared with 7 of 30 untreated babies). Amongst those treated with surfactant, we observed the persistence of acute alveolar damage with unresolved hyaline membrane disease in 5 infants who died at the ages of 5, 6, 10, 12, and 13 days, respectively, and histological evidence of pneumocyte type 2 hyperplasia and dysplasia in 2 infants who died at 22 and 41 days of age, respectively. These observations reveal that surfactant-treated infants who fail to respond to therapy have continuing alveolar injury and an increased incidence of intra-alveolar haemorrhage. Since oxygen radicals can induce pneumocyte damage and necrosis and since free radicals provoke alveolar haemorrhage in animal models, we propose that the lesions we observed may stem from a lack, in some preterm babies, of specific mechanisms that detoxify oxygen radicals.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 009274674

Download citation: RISBibTeXText

PMID: 8853843

DOI: 10.1159/000244343


Related references

The effects of surfactant and antenatal corticosteroid treatment on the pulmonary pathology of preterm infants with respiratory distress syndrome. Pathology, Research and Practice 205(1): 35-41, 2009

Pulmonary mechanics and energetics in preterm infants who had respiratory distress syndrome treated with synthetic surfactant. Journal of Pediatrics 120(2 Part 2): S18-S24, 1992

Long-term pulmonary consequences of respiratory distress syndrome in preterm infants treated with exogenous surfactant. Journal Of Pediatrics. 122(3): 446-452, 1993

Effect of exogenous surfactant therapy on levels of pulmonary surfactant proteins A and D in preterm infants with respiratory distress syndrome. Journal of Perinatal Medicine 37(5): 561-564, 2009

Pulmonary mechanics in ventilated preterm infants with respiratory distress syndrome after exogenous surfactant administration: a comparison between two surfactant preparations. Pediatric Pulmonology 18(5): 273-278, 1994

Indomethacin response in preterm infants with severe respiratory distress syndrome treated with human surfactant. Pediatric Research 19(4 Part 2): 354A, 1985

Fluid dynamics and renal function in preterm infants with respiratory distress syndrome treated with surfactant ta. Journal of the Iwate Medical Association 40(2): 201-210, 1988

Effects of bovine lipid extract surfactant administration in preterm infants treated for respiratory distress syndrome. Health Science Reports 1(4): E34, 2018

Modified bovine surfactant versus a protein-free surfactant in the treatment of respiratory distress syndrome in preterm infants A pilot study. Journal of the National Medical Association 86(1): 46-52, 1994

Activities of superoxide dismutase and catalase in tracheal aspirate fluid of surfactant treated preterm infants with respiratory distress syndrome. Zeitschrift fuer Geburtshilfe und Neonatologie 203(5): 201-206, 1999

Transient pulmonary function changes in preterm neonates with respiratory distress syndrome treated with porcine surfactant Predictive factors. Biology of the Neonate 67(4): 304, 1995

Early use of calf pulmonary surfactant in late preterm and full-term infants with respiratory distress syndrome: a randomized controlled trial. Zhongguo Dang Dai Er Ke Za Zhi 16(3): 285-289, 2014

A multicenter study on the surfactant treatment in late-preterm or term infants with respiratory distress syndrome. Zhonghua Er Ke Za Zhi 52(10): 724-728, 2014

Transient pulmonary function changes in ventilated preterm neonates with respiratory distress syndrome treated with natural porcine surfactant Predictive factors. Biology of the Neonate 67(Suppl. 1): 89-90, 1995

Effects of patent ductus arteriosus on left ventricular output and organ blood flows in preterm infants with respiratory distress syndrome treated with surfactant. Journal Of Pediatrics. 125(2): 270-277, 1994