Hyaline Membrane Disease Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Hyaline membrane disease occurs when the surfactant level in a baby’s body is insufficient. Surfactant is a substance that is produced in the airways and functions to open air sacs in the lungs so that the lungs can expand and oxygen can enter. A deficiency of this substance has the potential to cause the baby’s lungs to deflate and be damaged. As a result, the baby becomes difficult to breathe and looks very tight.
Normally, surfactant begins to be produced when the fetus is 24–28 weeks old. By the time he reaches 35 weeks, the amount of surfactant is generally adequate.
Hyaline membrane disease occurs in 60–80 percent of infants born prematurely before 28 weeks of age. Although most cases of hyaline membrane disease occur in premature babies, several conditions can increase a baby’s risk of being born with the disease, such as:
- Caucasian race and male gender
- History of previous births with hyaline membrane disease
- Baby born by cesarean section
- History of shortness of breath at birth
- Infection in pregnancy
- Twins
- Babies born to diabetic mothers
- Babies with patent ductus arteriosus (PDA) heart defects
Hyaline Membrane Disease Symptom
Symptoms and signs of hyaline membrane disease include:
- Severe shortness of breath
- Appears pale and bluish in the skin, especially the fingertips and lips
- There is nostril breathing
- Quick breath
- groaning
- You can see the pull of the chest muscles as an effort to breathe
These symptoms generally peak on the third day and subside when the baby can urinate.
Hyaline Membrane Disease Reason
Normally, babies born at full term have sufficient surfactant levels in their bodies. This surfactant is a substance that plays a role in keeping the airways open. When surfactant levels are below normal, for example due to prematurity, these airways become deflated and it becomes difficult for air to enter. This collapse of the airways in the lungs causes hyaline membrane disease. As a result, the baby has difficulty breathing and getting oxygen into the body.
If this difficulty breathing continues, over time lung function will also decrease. The impact will be a buildup of carbon dioxide and cause acidosis (blood pH becomes acidic). This acidosis condition is very dangerous because it can interfere with the body’s overall work.
In addition, without adequate treatment, the respiratory system will be exhausted and respiratory failure may occur. At the stage of respiratory failure, the baby’s body requires an additional tool to help him breathe, which is called a ventilator.
Hyaline Membrane Disease Diagnosis
The diagnosis of hyaline membrane disease is determined based on a detailed medical interview, physical examination, and supporting examinations. During the medical interview, it was traced whether there was a history of pregnancy and childbirth which could increase the risk of hyaline membrane disease. For example, infection during pregnancy, history of previous shortness of birth, and gestational age when the baby was born.
On physical examination, the following conditions will be found:
- baby who looks cramped
- looks pale or bluish on the tips of the hands, feet and lips due to lack of oxygen
- there is a pull on the chest muscles as an effort to breathe
Supporting examinations that can be done are:
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Oxymetry
On oximetry examination at the fingertips, oxygen levels were found to be below normal numbers.
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Chest X-ray
On a chest X-ray a baby with hyaline membrane disease will get a ground glass image of the lungs.
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Cardiac echocardiography
Cardiac echo or ultrasound of the heart is done to confirm if there is a patent ductus arteriosus (PDA). PDA is an abnormality of the heart which is a risk factor for hyaline membrane disease.
Hyaline Membrane Disease Treatment
Because the main problem in hyaline membrane disease is difficulty breathing, assisted breathing in infants is the main principle of treatment. Breathing assistance can be given by various methods, such as:
- Oxygen mask
- Inserting an auxiliary breathing tube through the mouth into the lungs
- Installing a breathing machine or ventilator
- Administration of artificial surfactants
- Giving sedatives, especially during medical procedures.
Hyaline Membrane Disease Complications:
Various complications can occur from hyaline membrane disease, including:
- Pneumomediastinum: escaping of air from the lungs into the lung lining spaces
- Pneumothorax: escaping of air from the lungs into the space between the lungs and the chest wall
- Pneumopericardium: passage of air into the cardiac chambers
- Pulmonary interstitial emphysema (PIE): escaping of air into the spaces between the air sacs in the lungs
- Chronic lung disease
Hyaline Membrane Disease Prevention
Hyaline membrane disease is prevented by minimizing the risk of preterm birth. If premature birth cannot be avoided, the mother can be given drugs in the form of corticosteroids which play a role in maturing the baby’s lungs.