A quantitative model for hyaline membrane disease

A model based on the course of 31 infants with uncomplicated hyaline membrane disease is described. Based on data collected over the first 12 hr of life, it predicts the course of an infant for the next 60 hr, and estimates the outcome in terms of length of oxygen requirement and assisted ventilation. For the construction of the model, right-to-left intra- and extra-pulmonary shunting, expressed as venous admixture, was considered as the principal mechanism of hypoxemia in hyaline membrane disease and mean applied proximal airway pressure was used to quantify management. The model provides an objective estimate of severity early in the course of the disease, uses variables routinely available in an intensive care unit, and its use would strengthen the interpretation of clinical studies in which the comparability of experimental and control groups is critical. Speculation: A quantitative model for hyaline membrane disease, which can group infants into severity categories and predict their expected course over the first 72 hr of life, provides an objective research tool to evaluate prospectively modifications or additions to current regimens of treatment.