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Recent Advances in Respiratory Medicine

There have been major advances in our understanding of the respiratory system in the foetus. We know that before birth the lungs are not collapsed, but have a fluid volume which is probably similar to the neonatal lung air volume of 35 ml lkg bodyweight. This fluid is produced in the foetal lamb at the rate of approximately 3 mllkg lhour (Platzker eta l . , 1975). If this fluid production were to continue after delivery, pulmonary oedema would almost inevitably result. Recent work (Olver, 1978) has shown that lung fluid production can be inhibited or even reversed by the administration of adrenalin to the foetus. There are other factors involved in the clearance of lung fluid, but this observation fits in well with the finding that catecholamine levels rise dramatically in the immediate neonatal period.