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Stable bubbles signal better breathing in neonate.

Because they lack surfactants, the alveoli of the immature fetal lung cannot form the stable bubbles that are required for normal breathing after birth, says Emile M. Scarpelli, MD, professor of pediatrics, physiology, and biophysics at Albert Einstein College of Medicine, Bronx, NY. Scarpelli's report was presented at the recent International Symposium on the Surfactant System of the Lung held in Rome. "At the onset of breathing, high concentrations of surfactants in the normal fetal lung permit that lung to form stable bubbles that establish themselves as tiny air pockets in the alveolar spaces," Scarpelli told JAMA MEDICAL NEWS. "Before that, these spaces are filled with liquid, so that with the first breath, the alveolus makes a transition from the liquid-filled to the air-filled state." To prove that these bubbles—only 40 to 200 μm in diameter—exist in the mature but not the immature fetal lung, Scarpelli and associates used an