(See also Overview of Perinatal Respiratory Disorders Overview of Perinatal Respiratory Disorders Extensive physiologic changes accompany the birth process (see also Neonatal Pulmonary Function), sometimes unmasking conditions that posed no problem during intrauterine life. For that reason... read more .)
Extensive physiologic changes Perinatal Physiology The transition from life in utero to life outside the womb involves multiple changes in physiology and function. See also Perinatal Problems. (See also Liver Structure and Function and Neonatal... read more accompany the birth process, sometimes unmasking conditions that posed no problem during intrauterine life. For that reason, a person with neonatal resuscitation Neonatal Resuscitation Extensive physiologic changes accompany the birth process, sometimes unmasking conditions that posed no problem during intrauterine life. For that reason, a person with neonatal resuscitation... read more skills must attend each birth. Gestational age Gestational Age Gestational age and growth parameters help identify the risk of neonatal pathology. Gestational age is the primary determinant of organ maturity. Gestational age is usually defined as the number... read more and growth parameters Growth Parameters in Neonates Growth parameters and gestational age help identify the risk of neonatal pathology. Growth is influenced by genetic and nutritional factors as well as intrauterine conditions. Growth parameters... read more help identify the risk of neonatal pathology.
Transient tachypnea of the newborn affects premature infants Preterm Infants An infant born before 37 weeks gestation is considered preterm. Prematurity is defined by the gestational age at which infants are born. Previously, any infant weighing < 2.5 kg was termed... read more , term infants delivered by elective cesarean delivery without labor, and infants born with respiratory depression, all of whom may have delayed clearance of fetal lung fluid. Part of the cause is immaturity of the sodium channels in lung epithelial cells; these channels are responsible for absorbing sodium (and thus water) from the alveoli. (Mechanisms for normal resorption of fetal lung fluid are discussed in Neonatal pulmonary function Neonatal Pulmonary Function The transition from life in utero to life outside the womb involves multiple changes in physiology and function. See also Perinatal Problems. (See also Liver Structure and Function and Neonatal... read more .) Other risk factors include macrosomia, maternal diabetes and/or asthma, lower gestational age, and male sex.
Symptoms and Signs
Transient tachypnea of the newborn is suspected when the infant develops respiratory distress shortly after birth.
Symptoms of transient tachypnea of the newborn include tachypnea, intracostal and subcostal retractions, grunting, nasal flaring, and possible cyanosis.
Diagnosis
Chest x-ray
Complete blood count (CBC) and blood cultures
Pneumonia Neonatal Pneumonia Neonatal pneumonia is lung infection in a neonate. Onset may be within hours of birth and part of a generalized sepsis syndrome or after 7 days and confined to the lungs. Signs may be limited... read more , respiratory distress syndrome Respiratory Distress Syndrome in Neonates Respiratory distress syndrome is caused by pulmonary surfactant deficiency in the lungs of neonates, most commonly in those born at < 37 weeks gestation. Risk increases with degree of prematurity... read more , and sepsis Neonatal Sepsis Neonatal sepsis is invasive infection, usually bacterial, occurring during the neonatal period. Signs are multiple, nonspecific, and include diminished spontaneous activity, less vigorous sucking... read more may have similar manifestations, so chest x-ray, CBC, and blood cultures usually are done. Chest x-ray shows normally inflated or hyperinflated lungs with streaky perihilar markings, giving the appearance of a shaggy heart border while the periphery of the lungs is clear. Fluid is often seen in the lung fissures.
If initial findings are indeterminate or suggest infection, antibiotics (eg, ampicillin, gentamicin) are given while awaiting culture results.
Treatment
Oxygen
Recovery usually occurs within 2 to 3 days.
Treatment of transient tachypnea of the newborn is supportive and involves giving oxygen and monitoring arterial blood gases or pulse oximetry.
Less frequently, infants with transient tachypnea of the newborn (TTN) may require continuous positive airway pressure Continuous Positive Airway Pressure (CPAP) Initial stabilization maneuvers include mild tactile stimulation, head positioning, and suctioning of the mouth and nose followed as needed by Supplemental oxygen Continuous positive airway... read more (CPAP) and occasionally even mechanical ventilation Mechanical Ventilation Initial stabilization maneuvers include mild tactile stimulation, head positioning, and suctioning of the mouth and nose followed as needed by Supplemental oxygen Continuous positive airway... read more .
A small number of infants with TTN may develop persistent pulmonary hypertension Persistent Pulmonary Hypertension of the Newborn Persistent pulmonary hypertension of the newborn is the persistence of or reversion to pulmonary arteriolar constriction, causing a severe reduction in pulmonary blood flow and right-to-left... read more or pneumothorax Pneumothorax Pulmonary air-leak syndromes involve dissection of air out of the normal pulmonary airspaces. (See also Overview of Perinatal Respiratory Disorders.) Extensive physiologic changes accompany... read more .
Drugs Mentioned In This Article
| Drug Name | Select Trade |
|---|---|
ampicillin |
Principen |
gentamicin |
Garamycin, Genoptic, Genoptic SOP, Gentacidin, Gentafair, Gentak , Gentasol, Ocu-Mycin |
