Transient Tachypnoea of the Newborn (TTN)

Last updated 10.01.14

 

Definition

-  Self limited non-infectious tachypnoea occuring in a newborn

 

Features

-  Common presentation

- Incidence around 1%

- Occurs within first few hours of life

-  After birth lung switches from Chloride secretion to Nodium absoprtion

- Process activated by catecholamines  

- Typically resolved within 24-72hrs

 

Cause

-  Delay in clearance of fetal lung fluid

 

Associated S/S

-  Increased oxygen requirement

- Tachypnoea >60 breaths/min

- +/- Nasal flaring

- +/- Grunting

- +/- Intercostal or subcostal retractions

- +/- Cyanosis (if severe)

-  Respiratory fatgiue

 

Risk Factors

-  LUSCS: lack of catacholamine surge

-  Particularly elective LUSCS or <39weeks

- Maternal asthma or smoking

- Macrosomia

 

DDx

-  Pneumonia

- MAS

- Sepsis

- Pneumomediastinum

- Persistent Pulmonary Hypertension

- RDS

 

Ix

- Vitals

- RR

- HR

- Temp: instablity, fever

- CRT: hydration, feeding adequacy

-  O2Sat  

-  +/- ABG/VBG

- BSL

- CXR

- Prominent perihilar streaking

- Patchy infiltrates

- Pleural effusion (small)

- Exclude pneumothorax, pneumediastinum, consolidation

 

Mx

-  Suportive management

- As retained fluid absorbed respiratory status will improve

- +/- Withhold oral feeing: IV fluids & gavage feeding until infant able to tolerate oral feeds

- +/- O2

- +/- Isolette to maintain temperature

- +/- FBE, CRP, BC

- Rarely require CPAP or ventilation

- +/- IV antibiotics for 48hrs until BC negative

- Benzylpenicillin 60mg/kg BD (if term)

- Gentamicin 4mg/kg Daily (if term)

 

 

 

References

 

eMedicine: TTN 2012