Persistent tachypnoea in neonates

May indicate mild pulmonary hypoplasia

Acute respiratory distress is common in newborn babies, and clear principles have been established for its management. The same is not true for persistent tachypnoea; in the neonatal period it is much less recognised, and advice on its recognition and management has been sparse.

Persistent tachypnoea in neonates is difficult to define. Respiratory disorders after birth are so common that persistent tachypnoea may not be recognised until after the first week of life. The upper limit for a normal respiratory rate is not clear. In one recent study of normal infants, 95% confidence intervals for respiratory rate during the neonatal period were 35 to 66 breaths a minute (range 30-76) in awake subjects and 27 to 54 (range 27-62) during sleep.1 Thus, the upper ranges of normality are high, and detecting clinically significant tachypnoea requires clinical judgment and consideration of associated features such as grunting and soft tissue recession.

Persistent tachypnoea has a …