Clinical History.—A 1,390 gm, 40 cm white female infant, the product of a 7½ month pregnancy, was delivered spontaneously and shortly after birth developed respiratory distress with weak, irregular, grunting respiration, intercostal retractions, and a dusky color. The infant was placed in an incubator (Isolette) and an umbilical vein catheter inserted. The blood culture was negative. Venous co2 content was 21.5, the pH 7.23, and the Pco2 49. The color improved with 30% oxygen, but the respiratory distress continued and the patient died at 40 hours of age.
Physical Examination.—The physical examination revealed an otherwise normal appearing premature infant in respiratory distress with bilateral crepitant rales and a respiratory rate of 60/min. The apical cardiac rate was 160/min. A chest roentgenogram was obtained (Fig 1) and a detail film of the findings in the right lung is illustrated (Fig 2).
Denouement and Discussion