Lung of the Newborn Infant.pdfVIP

CLIFFLIKE BOUNDARY marks the margin between the ciliated cells of a bronchiole, with their hairlike appendages (right and bottom), and the unciliated cells that line a cup·shaped alveolus, one of the terminal air spaces of the lung. The tissue, magnified 3,250 times in this scanning electron micrograph, is not from the 74 lung of an infant but from a laboratory animal with analogous lung structures; the animal is an adult rabbit. The micrograph was made by one of the authors (Nai.San Wang). The hole to the left of center is one of many pores of Kohn that open onto adjacent alveoli; the boulder·like bodies among the cilia are Clara cells. ? 1973 SCIENTIFIC AMERICAN, INC The Lung of the Newborn Infant Certain cells essential to lung function mature only shortly before birth. A way has been found to accelerate the development of these cells in order to prevent respiratory distress in premature infants by Mary Ellen Avery, Nai-San Wang and H. William Taeuscb, Jr. T he major challenge faced by an in- fant during birth is switching from one oxygen source to another. In the u.s. until recently some 25,000 in- fants died each year because they could not convert from oxygen obtained through the placenta to oxygen obtained through the lungs. Most of these infants were born before the normal 40 weeks of fetal growth and maturation. When such respiratory distress occurs, it has a pre- dictable time of onset: at the moment of birth or within minutes thereafter. Every infants first breath requires great effort. For infants with immature lungs the effort continues. Immature lungs cannot retain air, and as the first breath is exhaled the lungs air spaces empty completely and collapse. As a re- sult the infant finds each inhalation as difficult and demanding as the first. Af- ter a time plasma may begin to leak out of the lung tissue and coat the air spaces. This glassy pink coating gives respira- tory distress in the newborn the name hyaline membr