Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal respiratory disease.
Hypertension, Pulmonary ; Parturition ; Transient Tachypnea of the Newborn

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

Pneumocephalus is common after brain surgeries, but usually is not substantial enough to cause serious complications. We recently encountered a case of post-operative tachypnea after an endoscopic 3rd ventriculostomy. At first, we thought that the hyperventilation was the result of residual paralysis after emergence from anesthesia, but during further evaluation we found a massive pneumocephalus. In such unusual post-operative situations, physicians should consider surgery-related complications as the possible cause as well, along with the anesthetic factors.
Anesthesia ; Brain ; Hyperventilation* ; Paralysis ; Pneumocephalus* ; Postoperative Care ; Tachypnea ; Ventriculostomy*

PURPOSE: Transient tachypnea of the newborn (TTN) is a disorder caused by the delayed clearance of fetal alveolar fluid. beta-adrenergic agonists such as albuterol (salbutamol) are known to catalyze lung fluid absorption. This study examined whether inhalational salbutamol therapy could improve clinical symptoms in TTN. Additional endpoints included the diagnostic and therapeutic efficacy of salbutamol as well as its overall safety. METHODS: From January 2010 through December 2010, we conducted a prospective study of 40 newborns hospitalized with TTN in the neonatal intensive care unit. Patients were given either inhalational salbutamol (28 patients) or placebo (12 patients), and clinical indices were compared. RESULTS: The duration of tachypnea was shorter in patients receiving inhalational salbutamol therapy, although this difference was not statistically significant. The duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment were significantly shorter in the salbutamol-treated group. No adverse effects were observed in either treatment group. CONCLUSIONS: Inhalational salbutamol therapy reduced the duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment, with no adverse effects. However, the time between salbutamol therapy and clinical improvement was too long to allow definitive conclusions to be drawn. Further studies examining a larger number of patients with strict control over dosage and frequency of salbutamol inhalations are necessary to better direct the treatment of TTN.
Absorption ; Adrenergic beta-Agonists ; Albuterol* ; Humans ; Infant, Newborn ; Inhalation ; Intensive Care, Neonatal ; Lung ; Methods ; Oxygen ; Prospective Studies ; Tachypnea ; Transient Tachypnea of the Newborn*

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 > or =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 > or =72 hours. We need further study to find the way to reduce PTTN.
Anoxia ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Medical Records ; Oxygen ; Respiratory Insufficiency ; Respiratory Rate ; Risk Factors ; Tachypnea ; Transient Tachypnea of the Newborn ; Ventilators, Mechanical

A tracheostomy is the safest and popular method for maintaining airway. Recently, this method is interesting in neurosurgical unit respiratory care in brain damaged patients. Authors had performed a tracheostomy on 20 cases among the brain damaged patients and evaluated it's effect by PaO2 and PaCO2 change, respiratory and Glasgow coma scale change between pretracheostomic and posttracheostomic state. Also, it's complications were evaluated. The results are as follows ; 1) After tracheostomy, significant elevations were noted in mean arterial oxygen tension from 65.55+/-19.34mmHg to 85.83+/-33.53mmHg at 30mins, to 84.48+/-29.12mmHg at 60mins, to 97.00+/-21.25mmHg at 120mins. 2) After tracheostomy, significant changes were not noted in mean arterial carbon dioxide tension. 3) After tracheostomy, progressive decrease in mean respiratory rate per min. were noted from 27.6+6.44 to 21.89+2.79 during 24hrs. 4) After tracheostpmy, slight improvement in mean Glasgow coma scale were noted from 7.7+2.54 to 8.25+2.95 during 24hrs. 5) The complications occured in 5 cases. 4 cases of them were pneumonias and 1 case of them was hemorrhage. From above results, Authors conclude that tracheostomy improves poor clinical status including hypoxemia and tachypnea which have influence on brain metabolism in the brain damaged patients.
Anoxia ; Brain* ; Carbon Dioxide ; Glasgow Coma Scale ; Hemorrhage ; Humans ; Metabolism ; Oxygen ; Pneumonia ; Respiratory Rate ; Tachypnea ; Tracheostomy*

There are several diseases characterized by neurologic abnormalities and renal disease. Joubert syndrome is one of them. Joubert syndrome is a relatively rare autosomal recessive syndrome. The most significant and constant neurologic finding is hypoplasia of the cerebellar vermis. Joubert syndrome is associated with hypotonia, retinal dystrophy, abnormal eye movement, delayed development, abnormal respiratory pattern (neonatal episodic tachypnea or apnea) and nephronophthisis. We report a boy with Joubert syndrome associated with nephrocalcinosis and agenesis of the cerebellar vermis. This patient had also abnormal eye movement, hypotonia, abnormal respiratory pattern, delayed development and chronic renal failure.
Eye Movements ; Humans ; Kidney Failure, Chronic ; Male ; Muscle Hypotonia ; Nephrocalcinosis* ; Neurologic Manifestations ; Retinal Dystrophies ; Tachypnea

PURPOSE: We evaluated the clinical/laboratory characteristics and progress of pediatric patients hospitalized for pneumonia and laboratory-confirmed H1N1 influenza infection. METHODS: A total of 101 patients were enrolled. They were divided into 2 groups: group 1 with a fast respiration rate for age (n=66) and group 2 with an appropriate respiration rate for age (n=35). We retrospectively reviewed the medical charts to collect data on the hospitalized patients. RESULTS: Patients were significantly older in group 1 than in group 2 (median age, 7 vs. 4 years, p<0.001) and 59.0% were between 6 and 8 years of age. Sixteen patients (24.2%) in group 1 had underlying medical conditions, most of whom had asthma, and 50 were previously healthy. Oxygen saturation on admission day was significantly lower in group 1 than in group 2 (92% vs. 98%, p<0.001) and 42 patients (63.6%) in group 1 had hypoxia (oxygen saturation <= 92%). The frequency of lymphopenia was significantly higher in group 1 than in group 2 (n=59 vs. 11, p<0.001). Some patients in group 1 received systemic corticosteroid therapy, intravenous immunoglobulin infusion and oxygen supplement (n=28, n=16, n=48, respectively). The frequency of systemic corticosteroid therapy and oxygen supplement was higher in group 1 than in group 2 (p<0.001 for each). CONCLUSION: H1N1 influenza infection complicated by pneumonia can cause severe illness in previously healthy children more than 6 years old and in children with uncontrolled allergic disease. Multi-center studies are needed to evaluate the clinical and epidemiologic characteristics of pediatric patients with 2009 H1N1 influenza.
Anoxia ; Asthma ; Child ; Humans ; Immunoglobulins ; Influenza, Human ; Lymphopenia ; Oxygen ; Pneumonia ; Respiratory Rate ; Retrospective Studies ; Tachypnea

The classification of hiatal hernia is made by the position of the gastroesophageal junction. Although sliding hiatal hernia (type 1) is the most common type of hiatal hernia, it is very uncommon to be found in early infancy because it is usually symptom free. We report a case of type 1 hiatal hernia of newborn infant who had diagnosed by simple chest radiography taken because of transient tachypnea of the newborn.
Classification ; Esophagogastric Junction ; Hernia, Hiatal* ; Humans ; Infant, Newborn ; Parturition* ; Radiography ; Thorax ; Transient Tachypnea of the Newborn

A congenital hepatoportal arteriovenous fistula associated with an intrahepatic portal vein aneurysm is a rare type of arteriovenous malformation. Only 14 pediatric cases have been reported to the best of the authors' knowledge. An intrahepatic shunt between the portal and systemic veins is also relatively rare. We report a case of a congenital hepatoportal arteriovenous fistula associated with an intrahepatic portal vein aneurysm and a portohepatic venous shunt in a neonate who presented with tachypnea and melena.
Aneurysm* ; Angiography ; Arteriovenous Fistula* ; Arteriovenous Malformations ; Humans ; Infant, Newborn ; Melena ; Portal Vein* ; Tachypnea ; Veins