Transient tachypnea of the newborn

Infobox_Disease
Name = PAGENAME


Caption =
DiseasesDB = 32373
ICD10 = ICD10|P|22|1|p|20
ICD9 = ICD9|770.6
ICDO =
OMIM =
MedlinePlus = 007233
eMedicineSubj = ped
eMedicineTopic = 2597
eMedicine_mult = eMedicine2|radio|710
MeshID =

Transient tachypnea of the newborn (TTN, TTNB, or "Transitory tachypnea of newborn") is a respiratory problem seen in the newborn shortly after delivery. It consists of a period of rapid breathing (higher than the normal range of 40-60 times per minute). It is likely due to retained lung fluid, and common in 35+ week gestation babies who are delivered by caesarian section without labour. Usually, this condition resolves over 24-48 hours. Treatment is supportive and may include supplemental oxygen and antibiotics. The chest X-Ray shows hyperinflation of the lungs including prominent pulmonary vasular markings, flattening of the diaphragm, and fluid in the horizontal fissure.

Pathophysiology

# Due to the higher incidence of TTN in newborns delivered by caesarean section, it has been postulated that TTN could result from a delayed absorption of fetal lung fluid from the pulmonary lymphatic system. The increased fluid in the lungs leads to increased airway resistance and reduced lung compliance. It is thought this could be from lower levels of circulating catecholamines after a caesarean section and that these are necessary to alter the function of the ENaC channel to absorb excess fluid from the lungs.
# Pulmonary immaturity has also been proposed as a causative factor. Levels of phosphatidylglycerol (an indicator of lung maturity) was found to be negative in certain newborns.
# Mild surfactant deficiency has also been suggested as a causative factor.


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