Internal Medicine

Respiratory distress (neonate)

Tachypnea (RR >60/min) accompanied by chest retractions and/or grunt.


Pulmonary causes

Cause Time of onset Remarks
Respiratory distress syndrome First 6 hr of life Common in preterm neonates
Meconium aspiration syndrome First few hr of life Common in term, post-term and small for date babies; history of meconium stained liquor
Pneumonia Any age Often bacterial
Transient tachypnea of newborn First 6 hr after birth Tachypnea with minimal distress; lasts for 48-72 hr
Persistent pulmonary hypertension Any age Severe distress; cyanosis
Pneumothorax Any age Sudden deterioration; usually during assisted ventilation
Tracheoesophageal fistula, diaphragmatic hernia, lobar emphysema Any age May show associated malformations; polyhydramnios in oesophagal atresia

Non-pulmonary causes


  • Congestive heart failure; congenital heart disease


  • Hypothermia, hypoglycemia, metabolic acidosis


  • Asphyxia, cerebral oedema, haemorrhage

Chest wall:

  • Asphyxiating thoracic dystrophy, Werdnig-Hoffman disease


The Calgary Guide |

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