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Transient Tachypnea of the Newborn

Transient Tachypnea of the Newborn: Pathogenesis and clinical findings Cesarean delivery without labour Author: Tanis Orsetti Reviewers: Annie Pham Michelle J. Chen Dr. Jean Mah* * MD at time of publication Smoking during pregnancy Uncontrolled maternal asthma Uncontrolled maternal diabetes Dilution of surfactant ↑ Surface tension in alveoli ↓ Expansion/contraction of lungs (↓ pulmonary compliance) ↑ Work of breathing Maternal factors leading to impaired fetal lung development Lack of labour-induced hormone changes (i.e. cortisol, catecholamines) ↓ Alveolar fluid reabsorption through epithelial aquaporin channels ↑ Alveolar fluid in lungs Disruption of laminar flow in airways ↑ Resistance to airflow ↑ Lung expansion to compensate Limited surface area for gas exchange in the alveoli ↓ Ventilation Fluid buildup in the major bronchi in the perihilar region Prominent perihilar streaking on chest x-ray ↑ Intrathoracic pressure pushes the diaphragm down Blunting of costophrenic angle on chest x-ray Hyperinflation of lungs Expanded lung fields on chest x-ray ↑ Deoxygenated hemoglobin in the bloodstream Blue/purple discoloration of the skin particularly around the lips & fingers (cyanosis) ↓ Oxygenated hemoglobin in the bloodstream ↑ Nasal passage size allows for more air to enter the lungs with each breath Nasal flaring Scalene/intercostal/ sternocleidomastoid /abdominal muscle activation to assist with breathing Accessory muscle use ↓Oxygen saturation (SpO2) Neonate takes more breaths to compensate for limited oxygenation Respiratory rate > 60 breaths/minute (tachypnea) Transient Tachypnea of the Newborn Temporary respiratory condition in newborns characterized by impaired lung function and rapid breathing Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Oct 4, 2024 on www.thecalgaryguide.com