Treatment of Respiratory Distress Syndrome: Physiological Considerations About Respiratory Therapy

A new basis for the understanding of respiratory insufficiency of the premature infant was established when Avery and Mead [1] showed that the hyaline membrane disease, HMD, also called idiopathic respiratory distress syndrome, IRDS, was associated with surfactant deficiency of the alveolar air liquid interface. Particularly in the early seventies therapeutic progress was marked. However, new obstacles to further progress called for a deeper understanding of the pathophysiology behind respiratory insufficiency of the premature infant. The purpose of this paper is to illustrate some aspects of the physiological background to the respiratory distress syndrome in neonates and in older subjects and its treatment by respiratory therapy.