Predictable risk factors and clinical courses for prolonged transient tachypnea of the newborn

Chang, Ji Young; Kim, Chang Ryul; Kim, Ellen A; Kim, Ki Soo

Original Article

Korean Journal of Pediatrics 2010;53(3):349-357.
Published online March 15, 2010.

Predictable risk factors and clinical courses for prolonged transient tachypnea of the newborn

Ji Young Chang¹, Chang Ryul Kim², Ellen A Kim³, Ki Soo Kim³

¹Departments of Pediatrics, East-West Neo Medical center, Kyung Hee University, Seoul, Korea
²Department of Pediatrics, Hanyang University College of Medicine, Guri, Korea
³Department of Pediatrics, Asan Medical center, University of Ulsan College of Medicine, Seoul, Korea

지속성 신생아 일과성 빈호흡을 예측하게 하는 위험인자와 임상경과

장지영^¹^, 김창렬^²^, 김애란^³^, 김기수^³

^¹경희대학교 동서신의학병원 소아청소년과
^²한양대학교 의과대학 소아과학교실
^³울산대학교 의과대학 소아과학교실

Correspondence:
Chang Ryul Kim, Email: crkim@hanyang.ac.kr

Received: 15 November 2009 • Revised: 15 January 2009 • Accepted: 18 February 2010

Abstract

Purpose
: Transient tachypnea of the newborn (TTN) is usually benign and improves within 72 hours. However, it can also progress to prolonged tachypnea over 72 hours, profound hypoxemia, respiratory failure, and even death. The aim of this study is to find predictable risk factors and describe the clinical courses and outcomes of prolonged TTN (PTTN).
Methods
: The medical records of 107 newborns, >35+0 weeks of gestational age with TTN, who were admitted to the NICU at Seoul Asan Medical Center from January 2001 to September 2007 were reviewed. They were divided into 2 groups based on duration of tachypnea. PTTN was defined as tachypnea ≥72 hours of age, and simple TTN (STTN) as tachypnea <72 hours of age. We randomly selected 126 healthy-term newborns as controls. We evaluated neonatal and maternal demographic findings, and various clinical factors.
Results
: Fifty-five infants (51%) with total TTN were PTTN. PTTN infants had grunting, tachypnea >90/min, FiO2 >0.4, and required ventilator care more frequently than STTN infants. PTTN had lower level of serum total protein and albumin than STTN. The independent predictable risk factors for PTTN were grunting, maximal respiration rate >90/min, and FiO2 >0.4 within 6 hours of life.
Conclusion
: When a newborn has grunting, respiration rate >90/min, and oxygen requirement >0.4 of FiO2 within 6 hours of life, the infant is at high risk of having persistent tachypnea ≥72 hours. We need further study to find the way to reduce PTTN.

Key Words: Transient tachypnea of the newborn, Prolonged tachypnea, Risk factor