Transient Tachypnea of the Newborn Is Associated With an Increased Risk of Hospitalization Due to Respiratory Syncytial Virus Bronchiolitis.

BACKGROUND: Transient tachypnea of the newborn (TTN) is a self-limiting respiratory disorder, resulting from a failure to clear the lungs of perinatal fluid. As similar pathophysiologic features are present in children with respiratory syncytial virus (RSV) bronchiolitis, we hypothesized that these two conditions may be connected. METHODS: This was a population-based cohort study that included all children born in term (≥37 weeks of gestation) without congenital malformations in Finland between 1996 and 2015. Children diagnosed with TTN (International Statistical Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] code P22.1) after birth and children hospitalized because of RSV bronchiolitis (ICD-10 code J21.0) during first year of life were identified from the Medical Birth Register and National Hospital Discharge Register, respectively, and the data were linked. Logistic regression was used to analyze the association between these two conditions. RESULTS: Of the 1,042,045 children included in the study cohort, 16,327 (1.57%) were diagnosed with TTN at birth and 12,345 (1.18%) were hospitalized because of RSV bronchiolitis during the first year of life. The rate of RSV hospitalization was higher in children with a history of TTN compared with children without TTN diagnosis [260/16,327 (1.59%) vs. 12,085/1,025,718 (1.18%), respectively; P value <0.0001]. After adjusting for gestational age at birth, mode of delivery, gender, birth weight, multiple births, older siblings and maternal smoking, TTN was associated with increased risk for RSV hospitalization (odds ratio: 1.31, 95% confidence interval: 1.16-1.48). CONCLUSIONS: TTN diagnosis after birth was associated with increased risk for RSV hospitalization during the first year of life.

Impact of Time to Neonatal Transport on Outcomes of Transient Tachypnea of the Newborn.

OBJECTIVE: To assess effects of neonatal transport on transient tachypnea of the newborn (TTN) in outborn term neonates. STUDY DESIGN: This retrospective cohort study included 66 term neonates diagnosed with TTN and transported to the Osaka Women's and Children's Hospital neonatal intensive care unit between January 2003 and March 2018. A multivariate logistic regression analysis identified perinatal and neonatal transport factors associated with adverse short-term outcomes defined as mechanical ventilation >48 hours, continuous positive airway pressure >72 hours, pulmonary hemorrhage, and requirement for inhaled nitric oxide, thoracentesis, or surfactant replacement therapy. RESULTS: A lower gestational age (GA) (37.7 [37.2, 38.3] vs. 39.6 [37.8, 40.3] weeks, p = 0.002), longer time to neonatal transport (10.0 [4.3, 25.5] vs. 5.5 [2.7, 9.7] hours, p = 0.01), and higher respiratory rates during transport (70 [60, 85] vs. 60 [55, 78.8] breaths/min, p = 0.04) were significantly associated with adverse short-term outcomes. After adjusting for GA, sex, cesarean section, and time to neonatal transport, GA (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.24-0.87) and time to neonatal transport (OR, 1.07; 95% CI, 1.01-1.13) were significantly associated with adverse outcomes. CONCLUSION: Short-term adverse prognosis of TTN is strongly associated with a lower GA and longer time between birth and neonatal transport.

Different antibiotic strategies in transient tachypnea of the newborn: an ambispective cohort study.

The purpose of this study is to determine the outcome and infection-related events in neonates with transient tachypnea of the newborn (TTN) managed with an antibiotic initiation strategy. An ambispective cohort study was carried out to compare two different antibiotic strategies in of TTN patients. The first strategy is based on clinical risk evaluation, in which antibiotics are initiated according to clinical signs, while the other is a combined strategy that integrates information regarding clinical signs, perinatal risk factors, and lab-based surveillance of infectious indicators. The antibiotic use in the combined strategy group (n = 716) was lower than that of the control group (n = 769) (35.06 vs 54.75 %, P < 0.01). Outcomes including total duration of antibiotic therapy (5.45 ± 4.17 vs 5.18 ± 3.45 days, P = 0.36), mortality (0 vs 0), length of hospital stay (7.78 ± 4.20 vs 8.14 ± 3.62 days, P = 0.07), and hospital readmission (4.89 vs 4.94 %, P = 0.94) did not differ; nor did infection-related events such as nosocomial infection (2.93 vs 2.99 %, P = 0.95), infectious pneumonia (18.30 vs 19.90 %, P = 0.43), septicemia (1.96 vs 1.95 %, P = 0.99), and necrotizing enterocolitis (0.14 vs 0.26 %). CONCLUSION: The combined strategy effectively reduces antibiotic usage during incidences of TTN with no negative impact on the clinical outcome. WHAT IS KNOWN: • TTN is easy to be confused with infection only based on clinical signs. • Many TTN patients had been treated with unnecessary antibiotics. WHAT IS NEW: • Our combined strategy for TTN can reduce antibiotics usage. • New strategy did not increase the incidence of infection and adverse outcomes.

Surfactant treatment for neonatal respiratory disorders other than respiratory distress syndrome.

BACKGROUND: It is suggested that there may be expanded use of surfactant replacement for the neonatal diseases such as meconium aspiration syndrome (MAS), pneumonia and possibly bronchopulmonary dysplasia (BPD). OBJECTIVE: To evaluate the characteristics and short-term outcome of the neonates given exogenous surfactant because of the diseases other than respiratory disease syndrome (RDS). METHODS: This retrospective study included 35 neonates admitted to the neonatal intensive care unit from January 2012 to December 2012 for an expanded use of surfactant. Data related to gestational age, birth weight, gender and perinatal risk factors were obtained from the patients' records. The short-term prognosis was also noted. RESULTS: The diagnosis was sepsis in 16 patients, eight MAS, seven transient tachypnea of the newborns (TTN) and four BPD. Mean gestational age was 35.6 ± 4.5 weeks and mean birth weight was 2661 ± 981 g. Of overall cases, 65% were boys and 35% girls. The mortality rate was 17%. Of six fatal cases, three was with BPD, two with sepsis and one with MAS. CONCLUSION: We think that surfactant replacement may be life saver in the neonatal diseases other than RDS such as BPD, MAS and sepsis by rapidly improving oxygenation. Further investigation is necessary to validate the significance of expanded use of surfactant.

Polymorphism of the angiotensin-converting enzyme gene and angiotensin-converting enzyme activity in transient tachypnea of neonate and respiratory distress syndrome.

BACKGROUND: Transient tachypnea of neonate (TTN) and respiratory distress syndrome (RDS) of the newborn are the most common cause of early respiratory distress in the immediate neonatal period. There is increasing evidence to support the role for the activation of the renin angiotensin system during acute lung injury. OBJECTIVES: The purpose of this study was to determine if there is a relationship between angiotensin-converting enzyme (ACE) I/D polymorphism, ACE activity and TTN and respiratory distress syndromes. METHODS: Nineteen neonates with TTN, 20 neonates with RDS and 21 control infants are studied for ACE polymorphism and serum ACE activity. RESULTS: Twenty six (43.3%) patients have DD polymorphism, 19 (31.7%) patients have ID polymorphism and 15 (25%) patients have II polymorphism. Serum ACE activity is 43.5 ± 1.8 (40-46) U/L in DD, 31.5 ± 2.3 (28-36) U/L in ID and 22.1 ± 2.1(19-46) U/L in II patient. CONCLUSIONS: The study could not find any difference in DD alleles and ACE activity between control group and TTN group. ACE polymorphism was not different between RDS group and control group in this study.

Correlation between transient tachypnea of the newborn and wheezing attack.

BACKGROUND: Transient tachypnea of the newborn (TTN) is the most common cause of respiratory distress in newborns. Although associated with some morbidity, it is generally believed that once TTN resolves, there is no further increased risk for respiratory disease. However, in limited studies frequency of wheezing attacks is found to be increased in patients who had TTN diagnosis during the newborn period, in comparison to patients who had no respiratory problem. Thus, the question arises as to whether TTN is an innocent disease. METHODS: This study was done retrospectively. We recorded the demographic characteristics of 103 infants born between 17 October 2003 and 17 October 2004 at Zeynep Kamil Hospital and hospitalized because of TTN in the neonatal intensive care unit. In the second phase, we telephoned the parents of the 103 infants and asked about wheezing attacks. A total of 103 other infants, born during the same period, with no health problems during the newborn period, were included in the study as the control group and the same procedures were applied to them. RESULTS: The rate of wheezing attack among patients with TTN diagnosis was found to be significantly higher than that in patients who had no TTN diagnosis (P < 0.01). TTN was found to be an independent risk factor for wheezing attack (OR, 2.378; 95% CI, 1.20-4.70). CONCLUSION: In conclusion, we established that TTN is an independent risk factor for wheezing. In addition we also hypothesized that genetic and environmental interactions synergistically predisposed these children for future wheezing.

Surfactant deficiency in transient tachypnea of the newborn.

OBJECTIVE: To evaluate surfactant production and function in term neonates with transient tachypnea of the newborn (TTN). STUDY DESIGN: Samples of gastric aspirates collected within 30 minutes of birth from 42 term newborns with gestational age ≥ 37 weeks (21 patients with TTN and 21 control subjects), delivered via elective cesarean delivery, were analyzed with lamellar body count and stable microbubble test. RESULTS: Results of lamellar body counts and stable microbubble tests were significantly lower in the TTN group than in control subjects (P = .004 and .013, respectively). Lamellar body counts were significantly lower in infants with TTN requiring oxygen for ≥ 24 hours after birth than in infants requiring oxygen for < 24 hours (P = .029). When the cutoff point was 48 hours, the stable microbubble count was significantly lower in the group requiring oxygen for ≥ 48 hours than in the group requiring oxygen for < 48 hours (P = .047). CONCLUSIONS: Term infants with TTN had low lamellar body counts associated with decreased surfactant function, suggesting that prolonged disease is associated with surfactant abnormalities.

Taquipnea transitoria del recién nacido en el Hospital General Docente "Ciro Redondo García": Artemisa 2009 / Transitory taquipnea of the New Born One In The Educational General Hospital "Ciro Redondo García". Artemisa 2009

Entre 40-50 por ciento de los casos con síndrome de dificultad respiratoria (SDR) evolucionan como una Taquipnea Transitoria (TTRN). Se realizó un estudio retrospectivo descriptivo, con el objetivo de conocer el comportamiento de la (TTRN) en la Unidad de Cuidados Especiales de Neonatología (UCEN) del Hospital General Docente Ciro Redondo García, en el período comprendido enero 2008 hasta diciembre 2009. El universo fue 113 recién nacidos (RN) con SDR y 72 constituyeron la muestra con diagnóstico de (TTRN) por un muestreo no probabilístico. Se confeccionó un formulario y se recogieron variables relacionadas con el parto y examen físico del RN. Los datos se procesaron estadísticamente por el sistema Excel. Aproximadamente 3 de cada 4 RN con (TT) nacen por cesárea, a término, del sexo masculino, normopesos, conteo de apgar normal y tiempo de evolución inferior a 120 horas. Se concluye que el comportamiento de la TTRN en nuestro servicio resultó elevado(AU)

Among 40-50 percent of the cases with syndrome of breathing (SDR) they evolve like a transitory Taquipnea (TTRN). He/She was carried out a descriptive retrospective study, whith the objective of knowing the behaviour of the TTRN in the Unit of Special Cares of Neonatology (UCEN) of the educational general Hospital Ciro Redondo García, in the Period understood January 2008 until December 2009. The universe was 113 new born (RN) with SDR and 72 constituted the simple with diagnostic of TTRN for a sampling non probabilistic. A form was made and variables related with the childbirth and physical exam of the RN were picked up. The data were processed statistically by the system Excel. Approximately 3 of each 4 RN with (TT) they are born for caesarean operation, to term, of the masculine sex, norm weight, count of normal apgar and time of inferiority evolution at 120 hours. You conclude that the behaviour of the TTRN in our service is high(AU)