•Case Scenarios. A neutral thermal environment reduces the newborn's energy requirements and oxygen consumption.The causes of respiratory distress in newborns are summarized in Maternal asthma, male sex, macrosomia, maternal diabetes mellitus, cesarean deliveryHyperexpansion, perihilar densities with fissure fluid, or pleural effusionsDiffuse ground-glass appearance with air bronchograms and hypoexpansionDelayed; early onset is 1 to 3 days, late onset is 5 to 14 daysProlonged membrane rupture, maternal fever, group B streptococci colonizationPlacental transmission or aspiration of infected amniotic fluid (early onset)Extrapleural pressure exceeding intrapleural pressureMaternal diabetes, cesarean delivery, black race, maternal obesity, maternal selective serotonin reuptake inhibitor useNormal or cardiomegaly or pulmonary congestion or effusion if severeRetained fluid and/or incomplete alveolar expansionMaternal asthma, male sex, macrosomia, maternal diabetes mellitus, cesarean deliveryHyperexpansion, perihilar densities with fissure fluid, or pleural effusionsDiffuse ground-glass appearance with air bronchograms and hypoexpansionDelayed; early onset is 1 to 3 days, late onset is 5 to 14 daysProlonged membrane rupture, maternal fever, group B streptococci colonizationPlacental transmission or aspiration of infected amniotic fluid (early onset)Extrapleural pressure exceeding intrapleural pressureMaternal diabetes, cesarean delivery, black race, maternal obesity, maternal selective serotonin reuptake inhibitor useNormal or cardiomegaly or pulmonary congestion or effusion if severeRetained fluid and/or incomplete alveolar expansionThe most common etiology of respiratory distress in newborns is TTN, which occurs in about five or six per 1,000 births.TTN presents within two hours of birth and can persist for 72 hours. 4–6 Recognizing that ARDS in children is different than adults, an international panel of experts convened … Use a physiologic approach to understand and differentially diagnose the most common causes of respiratory distress in the newborn infant.
Target theophylline concentration is 10 to 20 mg/L.Consider bi-level continuous positive pressure to unload work of breathing.1 mg/kg/hr for sedation in critical care setting; bronchodilatory properties; increase airway secretions.Try to avoid neuromuscular blockade; permissive hypercapnia; pressure control/pressure-regulated volume control/pressure support ventilation; monitor peak to plateau pressure difference.Adapted from: Nievas IF, Anand KJ. Recognize respiratory distress in the pediatric population. Inspiratory stridor generally is a sign of obstruction above the vocal cords, while expiratory stridor is an indication of obstruction in the trachea. Tafari N. et al. - Causes of acute respiratory distress in children - Causes of acute pediatric upper airway obstruction - Emergency management of anaphylaxis in infants and children - Causes central cyanosis newborn - Causes of coma - Causes of acute muscle weakness in children - Pediatric causes metabolic acidosis - Congenital anomalies associated with stridor - Causes of stridor other than congenital anomalies Chang JY, Intrapartum antibiotics for known maternal Group B streptococcal colonization. The differential diagnosis of newborn respiratory distress is listed in Respiratory rate suppression from maternal narcotic useRespiratory rate suppression from maternal narcotic useRarely, newborns with RDS develop chronic lung disease or bronchopulmonary dysplasia. Auckland District Health Board. Auckland District Health Board. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome.