Respiratory distress in the newborn

Suzanne Reuter, Chuanpit Moser, Michelle Baack

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

• Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. • Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). • Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks' gestation. • Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34) • On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. • Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks' gestation (7) to prevent MAS.

Original languageEnglish (US)
Pages (from-to)417-428
Number of pages12
JournalPediatrics in review
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2014

Fingerprint

Meconium Aspiration Syndrome
Expert Testimony
Newborn Infant
Transient Tachypnea of the Newborn
Pneumonia
Induced Labor
Newborn Respiratory Distress Syndrome
Morbidity
Tachypnea
Perineum
Pregnancy
Meconium
Streptococcus agalactiae
Intratracheal Intubation
Antibiotic Prophylaxis
Centers for Disease Control and Prevention (U.S.)
Nose
Practice Guidelines
Surface-Active Agents
Respiratory Insufficiency

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Respiratory distress in the newborn. / Reuter, Suzanne; Moser, Chuanpit; Baack, Michelle.

In: Pediatrics in review, Vol. 35, No. 10, 01.10.2014, p. 417-428.

Research output: Contribution to journalArticle

Reuter, Suzanne ; Moser, Chuanpit ; Baack, Michelle. / Respiratory distress in the newborn. In: Pediatrics in review. 2014 ; Vol. 35, No. 10. pp. 417-428.
@article{ca0361ab60f546119acb3b8b4d9d95f4,
title = "Respiratory distress in the newborn",
abstract = "• Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. • Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). • Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks' gestation. • Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34) • On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. • Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks' gestation (7) to prevent MAS.",
author = "Suzanne Reuter and Chuanpit Moser and Michelle Baack",
year = "2014",
month = "10",
day = "1",
doi = "10.1542/pir.35-10-417",
language = "English (US)",
volume = "35",
pages = "417--428",
journal = "Pediatrics in Review",
issn = "0191-9601",
publisher = "American Academy of Pediatrics",
number = "10",

}

TY - JOUR

T1 - Respiratory distress in the newborn

AU - Reuter, Suzanne

AU - Moser, Chuanpit

AU - Baack, Michelle

PY - 2014/10/1

Y1 - 2014/10/1

N2 - • Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. • Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). • Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks' gestation. • Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34) • On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. • Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks' gestation (7) to prevent MAS.

AB - • Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. • Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). • Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks' gestation. • Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34) • On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. • Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks' gestation (7) to prevent MAS.

UR - http://www.scopus.com/inward/record.url?scp=84907750391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907750391&partnerID=8YFLogxK

U2 - 10.1542/pir.35-10-417

DO - 10.1542/pir.35-10-417

M3 - Article

C2 - 25274969

AN - SCOPUS:84907750391

VL - 35

SP - 417

EP - 428

JO - Pediatrics in Review

JF - Pediatrics in Review

SN - 0191-9601

IS - 10

ER -