Transient tachypnea of the newborn (TTN) is a benign, self-limited condition that can present in infants of any gestational age, shortly after birth. It is caused due to delay in clearance of fetal lung fluid after birth which leads to ineffective gas exchange, respiratory distress, and tachypnea. In the nursery, it often poses a significant, diagnostic dilemma in the care of newborn babies with respiratory distress.
Fetal risk factors include male gender, perinatal asphyxia, prematurity, small for gestational age, and large for gestational age infants.
The condition presents within the first few minutes to hours after birth.
Physical exam findings usually include signs of respiratory distress:
Other occasional exam findings:
Duration of respiratory distress is the principal determinant for diagnosis of TTN. If distress resolves within the first few hours of birth, it can be labeled as "delayed transition." Six hours is an arbitrary cutoff between "delayed transition" and TTN because by this time baby might develop issues with feeding and might require further interventions. TTN is usually a diagnosis of exclusion and hence any tachypnea lasting over 6 hours requires workup to rule out other causes of respiratory distress.
The workup usually includes:
Other workups to consider:
Given TTN is a self-limited condition, supportive care is the mainstay of treatment.
Overall prognosis is excellent with most of the symptoms resolving within 48 hours of onset.
In some case reports, malignant TTN has been reported in which affected newborns develop persistent pulmonary hypertension due to a possible elevation of pulmonary vascular resistance due to retained lung fluid.
What is transient tachypnea of the newborn?
Transient tachypnea of the newborn (TTN) is a condition that causes breathing problems in newborn babies. Babies have fluid in their lungs before birth. The fluid normally goes away when a baby is born. In some babies, the fluid does not go away as quickly as it should. This causes TTN.
A mother who has diabetes, asthma, or a C-section without labor is more likely to have a baby with TTN.
What are the symptoms of TTN?
How is TTN treated?
TTN usually goes away by the time a baby is 3 days old. Until that happens, doctors can help the baby get enough oxygen and nutrition if he or she needs it. Treatments might include:
Transient tachypnea of the newborn is a common condition seen in newborn babies. Healthcare workers including intensive care nurses need to know that the cause is due to fluid accumulation in the lungs. The condition is usually managed by an interprofessional team as there are many disorders which can present with similar symptoms. The condition, once diagnosed, is treated conservatively with oxygen, antibiotics, and sometimes with the use of a diuretic. The prognosis for most infants is excellent.
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