II. Epidemiology

  1. Most common cause of Newborn Respiratory Distress (40% of cases)
  2. Incidence: 5-6 per 1000 births

III. Pathophysiology

  1. Benign cause of Newborn Respiratory Distress
  2. Response to residual alveolar fluid following delivery (delayed reabsorption)
    1. Prostaglandin release typically increases with Vaginal Delivery
    2. Prostaglandins trigger lymphatic dilation and aid alveolar fluid clearance
  3. Surfactant deficiency may play a role
    1. However, surfactant replacement is not indicated

IV. Risk Factors

  1. Maternal factors
    1. Ceserean Section delivery
    2. Gestational Diabetes
    3. Maternal Asthma history
  2. Newborn factors
    1. Male gender
    2. Fetal Macrosomia

V. Signs

  1. Tachypnea
    1. Onset: Within 2 hours of delivery
    2. Duration: Hours to Days
      1. Initial higher Respiratory Rates predict a longer course

VI. Imaging: Chest XRay

  1. Diffuse parenchymal infiltrates especially perihilar
  2. Heart with surrounding "wet silhouette"
  3. Intralobar fluid
  4. Hyperexpansion

VII. Differential Diagnosis

VIII. Management

  1. See Respiratory Distress in the Newborn
  2. See Newborn Resuscitation
  3. Supportive care - generally improves spontaneously
  4. Nebulized Albuterol
    1. Reduces TTN duration and need for Supplemental Oxygen
  5. Consider fluid restriction
    1. Stroustrup (2012) J Pediatr 160(1): 38-43 [PubMed]
  6. Avoid potentially harmful or unhelpful measures
    1. Furosemide (Lasix) is not effective

IX. Complications

X. Prevention

  1. Avoid cesarean delivery before 39 weeks
  2. If cesarean delivery before 39 weeks cannot be avoided
    1. Corticosteroids (Betamethasone or Dexamethasone) at 48 hours before Cesarean Delivery (37-39 weeks)

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Ontology: Transitory tachypnea of newborn (C0158940)

Definition (MSH) Abnormal increase in RESPIRATORY RATE in the newborn. It is self-limiting and attributed to the delayed fetal lung fluid clearance often in CAESAREAN SECTION delivery.
Definition (NCI) A respiratory disorder characterized by higher than normal respiratory rates among premature and cesarean section delivered neonates whose lungs have not fully matured. The cause is often excess fluid in the lungs, and resolution is aided by supplemental oxygen and sometimes, antibiotics.
Concepts Disease or Syndrome (T047)
MSH D059245
ICD9 770.6
ICD10 P22.1
SnomedCT 7550008
English Transitory tachypnea of newborn, TTN - Transien tachypn newborn, Transient tachypnoe of newborn, transient tachypnea of newborn (diagnosis), transient tachypnea of newborn, Transient tachypnoea of the newborn, NB transitory tachypnea, Wet lung syndrome, Respiratory distress syndrome, type II, newborn tachypnea transient, transient tachypnea newborn, wet lung syndrome, Newborn Transient Tachypnea, Transient Tachypnea of the Newborn, Newborn Transient Tachypneas, Transient Tachypnea of Newborn, Transient Tachypnea of the Newborn [Disease/Finding], TTN, Transitory Tachypnea of Newborn, Idiopathic tachypnea of newborn, Tachypnea resolving about 6 hours postnatally, Newborn transitory tachypnea, Newborn transitory tachypnoea, TTN - Transient tachypnea of newborn, TTN - Transient tachypnoea of newborn, Transient tachypnea of newborn, Transient tachypnoea of newborn, Wet lung syndrome in newborn, Idiopathic tachypnoea of newborn, Tachypnoea resolving about 6 hours postnatally, Transitory tachypnoea of newborn, Transitory tachypnea of newborn (disorder), rapid; respiratory, transient, of newborn, respiration; rapid, transient, of newborn, Transient tachypnea of the newborn, transient newborn tachypnea, transient newborn tachypnoea, Tachypnea;transient;newborn, Tachypnoea;transient;newborn
Italian Tachipnea transitoria neonatale, Tachipnea transitoria del neonato
Dutch voorbijgaande tachypnoea van pasgeborene, ademhaling; snel, voorbijgaand, van pasgeborene, snel; ademhaling, voorbijgaand, van pasgeborene, Voorbijgaande tachypnoe van pasgeborene, voorbijgaande tachypnoea van de pasgeborene
Spanish Taquipnea transitoria del recien nacido, Taquipnea Transitoria del Recién Nacido, taquipnea que se resuelve alrededor de las 6 horas del período postnatal, taquipnea transitoria del recién nacido (trastorno), taquipnea transitoria del recién nacido, Taquipnea transitoria del recién nacido
Japanese 新生児一過性頻呼吸, シンセイジイッカセイヒンコキュウ
German Transitorische Tachypnoe beim Neugeborenen, Transiente Tachypnoe, Neugeborene, Transiente Tachypnoe Neugeborener, voruebergehende Tachypnoe Neugeborenes
Czech Přechodná tachypnoe novorozence, Transitorní tachypnoe novorozence, novorozenec - tachypnoe přechodná, tachypnoe novorozenců tranzitorní, přechodná tachypnoe novorozenců
Korean 신생아의 일과성 빠른호흡
Hungarian Újszülött átmeneti tachypnoe, Újszülöttkori átmeneti tachypnoe, Újszülött átmeneti tachypnoe-ja
French Tachypnée transitoire du nouveau-né
Polish Przemijające przyspieszenie akcji oddechowej noworodka, Przemijające przyspieszenie oddechu noworodka, Przyspieszony przemijający oddech noworodka, Przejściowe szybkie oddychanie noworodka, Tachypnoe noworodka przemijające, Przemijające tachypnoe noworodka, Przemijający szybki oddech noworodka, Oddech noworodka przyspieszony przemijający, Przejściowe przyspieszenie częstości oddechów noworodka, Przejściowy przyspieszony oddech noworodka
Norwegian Forbigående takypné hos nyfødt, Forbigående takypné hos nyfødte
Portuguese Taquipneia Transitória do Recém-Nascido, Taquipneia Transitória Neonatal, Taquipneia transitória do recém-nascido