Transient Tachypnea of the Newborn

[obliviousRN]

OK, so I had a newborn the other day that had some problems after birth. Came on at 30minutes of age. Started grunting, nasal flaring, faint crackles in lungs. Sats at 88%. Started baby on O2, kept them to be monitored. Baby was not tachypneic! RR was always within normal. Desat'd w/ crying or activity (diaper changes, etc) but would return to 95% within 25-30 second on the O2. Required this for 2 days then magically came out of it all and had no problems! MD kept calling it TTN, but baby was never tachypneic. Does that really matter or is it the comination of symptoms and not all have to match? I'm confused here.

[KRVRN, BSN, RN]

You don't always see tachypneia with TTN. What did the CXR show? Although I'm no good at reading them, I know RDS, TTN and pneumonia all show subtle differences. It probably was TTN because anything else probably wouldn't have been fixed without more intervention.

[MommyLauraRN]

I've always referred to TTN as benign tachypnea with a RR usually in the 70's-80's, but no grunting/flaring/retracting/desatting or abnormal lung sounds. With TTN, you can check the baby's RR a little later and it will be WNL. It sounds like the baby had a rough time transitioning and needed the extra 02 support for a couple days to keep his sats up so he didn't get worse...