RAPID GROWTH AND CENTROLOBULAR EMPHYSEMA AFTER STENOSING TRACHEITIS AND CONTINUOUS EXPOSURE TO LOW CONCENTRATIONS OF OXYGEN

An 846 g newborn survives critical apnea, pseudomonad pneumonia and stenosing tracheitis, and thrives during 3 months of exposure to 40% oxygen. When he dies unexpectedly during an excellent convalescence, his lungs show a surprisingly advanced centro‐lobular emphysema. The history excites skepticism about the clinical evaluation of “silent” lungs of newborns, and demonstrates how remarkable a disparity may exist between ventilatory function and morphological damage in newborns. The possibility for contributory etiological roles is discussed for oxygen therapy, tracheal obstruction and rapid growth, but not for pneumonia. The case recalls the disturbing increase in neonatal emphysema since 1960. Restricted use of the term, Wilson‐Mikity disease, is urged while generic use of the term, lobular emphysema, is condoned.

[1]  R. Rosan,et al.  The Unit Lobule: A Revised Concept of the Neonatal Lung1 , 1971 .

[2]  R. Castellino,et al.  Radiologic and Histologic Investigation of Pulmonary Oxygen Toxicity in Newborn Guinea Pigs , 1990, Investigative radiology.

[3]  W. Northway,et al.  OXYGEN THERAPY HAZARDS IN THE NEONATE , 1970 .

[4]  R. Wise.  Gallbladder Disease—An Interdisciplinary Problem , 1969 .

[5]  A. Bignami,et al.  The effects of chronic hypoxia on the neonatal and infantile brain. A neuropathological study of five premature infants with the respiratory distress syndrome treated by prolonged artificial ventilation. , 1969, Brain : a journal of neurology.

[6]  P. Auld,et al.  Radiologic findings in the lungs of prematureinfants , 1969 .

[7]  W. Northway,et al.  Radiographic features of pulmonary oxygen toxicity in the newborn: Bronchopulmonary dysplasia. , 1968, Radiology.

[8]  C. Godard,et al.  Etude du métabolisme de l'aldostérone dans un cas de diabète insipide néphrogénique congénital , 1968, Pediatric Research.

[9]  E. Reynolds,et al.  Pulmonary surface tension and pathological changes in infants dying after respirator treatment for severe hyaline membrane disease. , 1967, Lancet.

[10]  E. Weibel,et al.  DEVELOPMENT OF FINE STRUCTURAL DAMAGE TO ALVEOLAR AND CAPILLARY LINING CELLS IN OXYGEN-POISONED RAT LUNGS , 1967, The Journal of cell biology.

[11]  W. Northway,et al.  Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. , 1967, The New England journal of medicine.

[12]  U. Rudhe,et al.  Roentgenological observations in survivors of clinical hyaline membrane disease of the newborn. , 1967, Annales de radiologie.

[13]  M. Klaus,et al.  PROLONGED RESPIRATOR USE IN PULMONARY INSUFFICIENCY OF NEWBORN. , 1965, JAMA.

[14]  Avery Me,et al.  A form of pulmonary insufficiency in premature infants. Pulmonary dysmaturity , 1963 .

[15]  O. Baghdassarian,et al.  A form of pulmonary insufficiency in premature infants. Pulmonary dysmaturity? , 1963, The American journal of roentgenology, radium therapy, and nuclear medicine.

[16]  M. Wilson,et al.  A new form of respiratory disease in premature infants. , 1960, A.M.A. journal of diseases of children.

[17]  A. Patz.  The role of oxygen in retrolental fibroplasia. , 1957, Pediatrics.

[18]  J. Fawcitt.  Radiological Findings in the Lungs of Premature Infants , 1956, Archives of disease in childhood.