Taquipnea Transitoria Del Recien Nacido

Newborn Respiratory Disorders
Jamie B. Warren and JoDee M. Anderson
Pediatr. Rev. 2010;31;487-496
DOI: 10.1542/pir.31-12-487

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Article

fetus and newborn

Newborn Respiratory Disorders
Jamie B. Warren, MD,*
JoDee M. Anderson, MD,
MEd*

Author Disclosure
Drs Warren and
Anderson have
disclosed no financial
relationships relevant
to this article. This
commentary does not
contain a discussion
of an unapproved/

ObjectivesAfter completing this article, readers should be able to:

1. Evaluate and diagnose the most common causes of respiratory distress in the newborn
period.
2. Differentiate between the normal results of a newborn chest radiograph and the
radiographic patterns that reflect neonatal respiratory distress syndrome, meconium
aspiration syndrome, retained fetal lung liquid syndrome, and neonatalpneumonia.
3. Recognize subglottic stenosis as a complication of endotracheal intubation.
4. Distinguish between pulmonary disease and cyanotic congenital heart disease as a
cause of hypoxemia and acidosis in the neonate.
5. Discuss common complications of various respiratory disorders (such as meconium aspiration syndrome) and the untoward effects of specific therapies (intubation and mechanicalventilation).
6. Describe how chronic lung disease may result from meconium aspiration.

investigative use of a
commercial product/
device.

Introduction
Neonatal respiratory disorders account for most admissions to intensive care units in the
immediate newborn period. Newborns in respiratory distress must be evaluated promptly
and accurately; occasionally, neonatal respiratory distressis life-threatening and requires
immediate intervention. The causes of respiratory distress in the newborn are numerous
and are due to pulmonary or nonpulmonary processes. (1) Initial stabilization of the
neonate, through management of the airway, breathing, and circulation, takes precedence
over determining the cause. A thorough initial assessment, including maternal and
neonatal history,physical examination, and appropriate use of diagnostic tests, is essential
to diagnosing the cause of respiratory distress.

Definition
Abbreviations
ABG:
BPD:
CBC:
CLD:
CPAP:
ECMO:
FiO2:
GBS:
iNO:
MAS:
NRP:
PaCO2:
PaO2:
RDS:
RFLLS:

arterial blood gas
bronchopulmonary dysplasia
complete blood count
chronic lung disease
continuous positive airway pressure
extracorporealmembrane oxygenation
fraction of inspired oxygen
group B Streptococcus
inhaled nitric oxide
meconium aspiration syndrome
Neonatal Resuscitation Program
partial pressure of arterial carbon dioxide
partial pressure of arterial oxygen
respiratory distress syndrome
retained fetal lung liquid syndrome

Respiratory distress in the neonate most commonly presents as
one or all of the followingphysical signs: tachypnea, grunting,
nasal flaring, retractions, and cyanosis. (2) A normal respiratory
rate in a newborn is between 30 and 60 breaths/min; tachypnea is classified as respiratory rates greater than 60 breaths/
min. Patients born with surfactant deficiency and poorly compliant lungs have rapid, shallow breathing. Infants experiencing
increased airway resistance, such as those who...