What is Hyaline Membrane Disease?

Hyaline membrane disease (HMD) is a respiratory condition which affects infants, typically premature infants born at less than 35 weeks of gestation. This condition is fatal if not treated, and it is a common cause of death for premature infants. A number of techniques can be used to address hyaline membrane disease.

When infants are born prematurely, their lungs have often not started producing enough surfactant. Surfactant is a fluid which maintains the surface tension in the lungs, allowing people to breathe in and out freely. Without surfactant, the inflatable alveoli in the lungs will collapse, gradually cutting off the supply of oxygen to the blood and eventually causing death. In hyaline membrane disease, the lack of surfactant causes difficulty breathing, and a layer of debris and dead tissue builds up in the lungs, effectively cutting off the supply of oxygen entirely.

This layer of material closely resembles hyaline cartilage, so named because it has a slightly glassy appearance and “hyaline” means “like glass.” Most doctors actually prefer to refer to this condition as respiratory distress syndrome (RDS) or infant respiratory distress syndrome (IRDS). If a patient is born with this condition and no treatment is offered, he or she has three to four days to live.

In most cases, the condition is simply caused by being born too soon. Some babies also have a genetic defect which prevents them from producing as much surfactant as they need. In either case, the treatment involves giving the baby oxygen-rich air, and supporting the baby if he or she starts to have severe trouble breathing. A ventilator may be used to help the baby breathe while the lungs develop surfactant. Infants can also be treated with artificial surfactant dripped into their lungs.

The best treatment for hyaline membrane disease is keeping the baby in the womb as long as possible, so that the condition is avoided altogether. If a woman appears to be at risk of premature labor, she may also be given steroids to help the baby's lungs develop more quickly in the event that he or she needs to be delivered early.

It is very easy to recognize a baby with hyaline membrane disease. The baby has extreme difficulty breathing, and may grunt or cough in an attempt to get air into its lungs. Commonly the infant also starts to become cyanotic due to lack of oxygen circulation, turning bluish along the extremities or around the lips and mouth. Because premature babies are at high risk for hyaline membrane disease, the doctor will usually examine a premature infant closely for any signs of respiratory distress so that interventions can be provided quickly.