Immature lung problems: Can our nomenclature be more specific?

Since the advent of surfactant therapy for hyaline membrane disease, the problems associated with this condition have been greatly reduced in severity and morbidity. However, many premature infants who recover from the biochemical problem of surfactant deficiency still suffer from structural immaturity of the lungs. This aspect of lung immaturity centers primarily around pulmonary hypoplasia, for these infants, because they are immature, have fewer than normal alveoli and thus cannot accomplish adequate gas exchange. As a result, they are placed on long-term ventilator therapy, which renders them susceptible to problems associated with hypoxia, oxygen toxicity, and barotrauma. Over the last two decades, we have learned a great deal about the pathophysiology of these problems, and we believe that the terminology used to describe them may now be less than accurate. We suggest that the it be adjusted to more correctly reflect the problems seen in these infants.