RESPIRATORY DISTRESS SYNDROME-Reply FREE

To the extent that RDS is primarily a disease of premature infants, we would agree that prematurity itself may thus be a factor in the pathogenesis of the cases reported in our paper. However, we can only record and report the experiences that occurred in our institution where a group of infants with repeated attacks of bronchiolitis occurring at a relatively early age and of sufficient severity to require both multiple hospital admissions and in some instances respirator management was associated with an alarmingly frequent antecedent history of RDS in far greater proportion than had been anticipated from the known incidence figures for RDS in premature infants.¹ Moreover, as noted in the paper, the only three children requiring mechanical ventilatory support in our hospital during this entire period for bronchiolitis were all RDS survivors, suggesting a more than just fortuitous relationship between the two.