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Joseph Junewick, MD FACR
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Transient Tachypnea of the Newborn

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
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History

Newborn male with tachypnea.


Case Images


Diagnosis

Transient tachypnea of the newborn

Findings

CR – Cardiomegaly, vascular congestion and small right pleural effusion. Followup radiograph the following day is normal.

Discussion

Transient tachypnea of the newborn, also known as “wet lung disease” or “retained fetal lung fluid” is a condition in which the newborn experiences symptoms of respiratory distress, usually a respiratory rate greater than 60 breaths per minute, retractions, and/or grunting. Occasionally hypoxia is present and supplemental oxygen is needed. This condition is due to retained fluid in the newborn lung that has not been adequately evacuated in the perinatal period. Typically, 30% of fetal lung fluid is resorbed by lymphatics, 40% is resorbed by capillaries, and 30% is “squeezed” out as the infant traverses the birth canal. Cesaerean section without labor, for instance, undermines the fetal “”squeeze” process, and results in a higher incidence of transient tachypnea. Chest radiographs may show increased perihilar vascular markings, course, linear interstitial opacities, fluid in the fissures; patchy areas of alveolar opacification, small pleural effusions, and occasionally mild cardiomegaly and hyperinflation. Successive images within a few days span should show rapid improvement. Clinical and radiological resolution occurs within 72 hours. The differential diagnosis of TTN would include infant respiratory distress syndrome, meconium aspiration, neonatal pneumonia, and causes of pulmonary edema (including left-right shunt with failure, anomalous venous drainage, etc.).

Reference

Cleveland RH: A radiographic update on medical diseases of the newborn chest. Pediatric Radiology (1995); 25: 631-637.

Guglani L, Lakshminrusimha S, Ryan R: Transient tachypnea of the newborn. Pediatrics in Review (2008); 29:59-65.

Contributor

Daniel Dykstra, MD



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