Transient tachypnea of the newborn: Difference between revisions

Revision as of 02:03, 24 November 2014

See Newborn Resuscitation for immediate after-delivery resuscitation

Respiratory distress affects 1% of neonates:
- RDS (hyaline membrane disease) ~50%
- TTN ~50%
Self-limiting disease that resolves with days as retained lung fluid at birth is removed by lymphatics and breathing
1/3 of fluid cleared days before birth, 1/3 during active labor, 1/3 during crying/breathing
Risk factors
- C-section and rapidly born infants (lack of active labor)
- Infants of diabetic mothers
- SGA, preterm infants

Respiratory distress in first few hrs of life
- Tachypnea > 40-60 breaths/min
- Increased O2 requirement - > 60% or mechanical ventilation need consideration of other differentials
- Normal repeat ABGs (acceptable ranges/expected progression below):

Subject	PO2 mmHg	PCO2 mmHg	pH	Bicarb
< 28 wks	50-65	40-50	>7.28	18-24
38-49 wks	50-70	40-50	>7.3	20-24
Term (10 min)	50	48	7.2	-
Term (1 hr)	70	35	7.35	-
Term (1 wk)	75	35	7.4	-
Preterm 1.5 kg	60	38	7.37	-

Authors:

@@ Line 25: / Line 25: @@
 **Tachypnea > 40-60 breaths/min
 **Increased O2 requirement - > 60% or mechanical ventilation need consideration of other differentials
-**Normal repeat ABGs (references below):
+**Normal repeat ABGs (acceptable ranges/expected progression below):
 {| class="wikitable"
 |-
-! Subject !! Age !! PO2 mmHg !! PCO2 mmHg !! pH
+! Subject !! PO2 mmHg !! PCO2 mmHg !! pH !! Bicarb
 |-
-| Term ||10 min || 50 || 48 || 7.2
+| < 28 wks || 50-65 || 40-50 || >7.28 || 18-24
 |-
-| Term || 1 hr || 70 || 35 || 7.35
+| 38-49 wks || 50-70 || 40-50 || >7.3 || 20-24
 |-
-| Term || 1 wk || 75 || 35 || 7.4
+| Term (10 min) || 50 || 48 || 7.2 || -
 |-
-| Preterm 1.5 kg || 1 wk || 60 || 38 || 7.37
+| Term (1 hr) || 70 || 35 || 7.35 || -
+|-
+| Term (1 wk) || 75 || 35 || 7.4 || -
+|-
+| Preterm 1.5 kg || 60 || 38 || 7.37 || -
 |-