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
장지영1, 김창렬2, 김애란3, 김기수3
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


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