Probable Prognostic Factors among the Revealing Clinical Manifestations at Admission in Neonates with Tachypnea

ABSTRACT

PURPOSE: This study is for being aware of clinical manifestations in neonates with tachypnea; discussing the early clinical characteristics that would lead to prolonged symptoms; and investigating the predictive factors that would cause more morbid and progressive diseases other than transient tachypnea of the newborn (TTN). METHODS: Based on the medical records, we retrospectively investigated 44 neonates who were admitted to the neonatal intensive care unit in Dongguk University Hospital of Pohang for tachypnea, from March 1, 2003 to December 31, 2005. RESULTS: The patient characteristics showed male predominance of 2.61. Among the 44 neonates with tachypnea, TTN (24 cases, 54.5%) showed the highest incidence, followed by pneumonia (6 cases, 13.6%), idiopathic respiratory distress syndrome (5 cases, 11.4%), meconium aspiration syndrome (4 cases, 9.1%), cardiac disease (2 cases, 4.5%), sepsis (2 cases, 4.5%) and neonatal asphyxia (1 case, 2.3%). We compared TTN group with other groups including pneumonia, idiopathic respiratory distress syndrome, and meconium aspiration syndrome. We observed less incidence of premature rupture of membrane (PROM) (P<0.05); less likely to develop tachypneic symptom after 12 hours postpartum (P<0.05); shorter duration of tachypneic symptom (P<0.05); and less incidence of nasal flaring (P<0.05) in TTN group. CONCLUSION: The higher chance of pulmonary complications was observed in tachypneic neonates with either history of PROM or onset of tachypneic symptom after 12 hours postpartum. The prolonged tachypneic symptom and combined pulmonary complications were seemed to be accompanied with neonates showing nasal flaring.