Studies on Prolonged Respiratory Distress

Five handred sixty eight premature infants were admitted in the premature nursery of Kansai Medical University Hospital during 8 years from 1968 to 1975.102 infants of them developed IRDS, among whom 26 cases showed a course of Prolonged Respiratory Distress, suffering from tachypnea and cyanosis over four weeks duration. The author investigated clinically on these infants, especially on effects of oxygen administration for development of “Prolonged Respiratory Distress”, and the following results were obtained.(1) Out of twenty six Prolonged Respiratory Distress infants, eleven infants revealed characteristic signs of W-M Syndrome on chest x-ray finding. Two infants died of W-M Syndrome. All of twenty six Prolonged Respiratory Distress infants were born before 38 weeks of gestation and thein birthweights were under 2000g, several of them were small for dates babies.(2) Oxygen (FiO2,23-37%) were administered to prolonged respiratory distress infants untill central cyanosis was subsided. The durations were longer than 2 weeks, sometimes as long as 4 weeks.11 infants out of 26 prolonged respiratory distress revealed characteristic features of W-M Syndrome in chest x-ray. The W-M Syndrome Cases recieved oxygen therapy for 34 days in average, but O2 concentration administered was relatively low as 23-37%.(3) In this study series the author paid eff erts to shorten duration of O2 admimistration. Nevertheless, central cyanosis made it evitable to administer O2 longer than two weeks. Tachypnea had nothing to do with a reason of oxygen therapy.(4) Prolonged respiratory distress was diagnosed by long st anding respiratory distress with tachypnea and cyanosis longer than 4 weeks and characteristic finding of empyssma found in chest x-ray.(5) 45% of prolonged respiratory distress infants developed socalled lacey pattern (or bubbly pattern) in chest x-ray and became into W-M Syndrome.(6) Two out of eleven W-M Syndrome died of cor pulmo nale and their clinical coures were described in details, with histological findings. Prolonged Respiratory distres is a chinical course of recovery from IRDS, and an extrmely severe case is W-M Syndrome. Duration of O2 administration may have something to do with development of PRD from IRDS.