0:00

So this is a, uh, newborn infant who was born preterm,

0:04

who had respiratory distress.

0:06

So on this, uh, first image, uh, of this patient,

0:10

we have an enteric tube that's cosing into the stomach.

0:12

Looks like a normal course.

0:14

The lungs are diffusely abnormal.

0:16

It looks like granular salt

0:18

and pepper sand opacities diffusely throughout all lobes

0:22

of this, um, infant's chest.

0:24

We also have some increased conspicuity

0:26

of these central air bronchos.

0:28

So this is a pretty classic presentation

0:30

of surfactant deficiency.

0:33

This same infant just a few hours later was imaged

0:37

and you can see that the opacities have diffusely worsened.

0:40

So we have diffuse worsening

0:42

of micro atelectasis throughout the lungs.

0:44

They have placed an endotracheal tube.

0:46

The tip looks pretty okay in position,

0:48

but they have not yet given exogenous surfactant.

0:51

And so this is a nice example of the progression of

0:55

surfactant deficiency prior

0:57

to exogenous surfactant administration

0:59

where we have diffused micro atelectasis with worsening

1:03

of opacities and

1:04

therefore we have obscuration of not only our heart border,

1:08

but both of our hemi diaphragms.

1:10

So we would call this pretty severe surfactant deficiency

1:13

and we have these gorgeous central air broncho grams.

1:17

So, uh, we see these air bronchos

1:19

'cause of that micro atelectasis.

1:22

Last but not least, we have a third

1:23

and final image on the same day of this infant where, uh,

1:27

the endotracheal tube is still in place

1:29

after they have given exogenous surfactant.

1:31

But look how much better this long aeration looks.

1:35

Um, those granular opacities diffusely throughout the lungs

1:38

have nearly completely resolved.

1:40

We do still have some lactus at the, at the,

1:42

at the lower lung zones, but so much improved duration.

1:46

Our lung volumes are now symmetric

1:48

and normal in this infant, um, with lung disease

1:50

of prematurity, but post surfactant administration.

Case: Surfactant Deficiency

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0:00

So this is a, uh, newborn infant who was born preterm,

0:04

who had respiratory distress.

0:06

So on this, uh, first image, uh, of this patient,

0:10

we have an enteric tube that's cosing into the stomach.

0:12

Looks like a normal course.

0:14

The lungs are diffusely abnormal.

0:16

It looks like granular salt

0:18

and pepper sand opacities diffusely throughout all lobes

0:22

of this, um, infant's chest.

0:24

We also have some increased conspicuity

0:26

of these central air bronchos.

0:28

So this is a pretty classic presentation

0:30

of surfactant deficiency.

0:33

This same infant just a few hours later was imaged

0:37

and you can see that the opacities have diffusely worsened.

0:40

So we have diffuse worsening

0:42

of micro atelectasis throughout the lungs.

0:44

They have placed an endotracheal tube.

0:46

The tip looks pretty okay in position,

0:48

but they have not yet given exogenous surfactant.

0:51

And so this is a nice example of the progression of

0:55

surfactant deficiency prior

0:57

to exogenous surfactant administration

0:59

where we have diffused micro atelectasis with worsening

1:03

of opacities and

1:04

therefore we have obscuration of not only our heart border,

1:08

but both of our hemi diaphragms.

1:10

So we would call this pretty severe surfactant deficiency

1:13

and we have these gorgeous central air broncho grams.

1:17

So, uh, we see these air bronchos

1:19

'cause of that micro atelectasis.

1:22

Last but not least, we have a third

1:23

and final image on the same day of this infant where, uh,

1:27

the endotracheal tube is still in place

1:29

after they have given exogenous surfactant.

1:31

But look how much better this long aeration looks.

1:35

Um, those granular opacities diffusely throughout the lungs

1:38

have nearly completely resolved.

1:40

We do still have some lactus at the, at the,

1:42

at the lower lung zones, but so much improved duration.

1:46

Our lung volumes are now symmetric

1:48

and normal in this infant, um, with lung disease

1:50

of prematurity, but post surfactant administration.

Report

Text

Faculty

Judy H. Squires, MD

Associate Professor of Radiology

UPMC Children's Hospital of Pittsburgh

Lesson

Introduction

Lesson

Neonatal Brain

Lesson

Neonatal Spine

Lesson

Neonatal Chest: Support Devices

Lesson

Neonatal Chest: Newborn Lung Disease/Complications

Lesson

Neonatal Chest: Congenital Lung Lesions and Cardiac Diseases

Lesson

Neonatal Gastrointestinal: Necrotizing Enterocolitis

Lesson

Neonatal Gastrointestinal: Proximal and Distal Obstructions

Lesson

Neonatal: Genitourinary Imaging

Case: Surfactant Deficiency