Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ One of the most common symptom complexes of the newborn may result from cardiopulmonary and noncardiopulmonary causes Most of the noncardiopulmonary causes can be ruled out by the history, physical examination, and a few simple laboratory tests. Most common pulmonary causes of respiratory distress in the full-term infant are transient tachypnea, aspiration syndromes, congenital pneumonia, and pneumothorax +++ Clinical Findings ++ Tachypnea, respiratory rate > 60 breaths/min Intercostal and sternal retractions Expiratory grunting Cyanosis in room air +++ Diagnosis ++ Chest radiography, arterial blood gases, and pulse oximetry are useful in assessing the cause and severity of the distress +++ Treatment ++ Supplemental oxygen sufficient to maintain a PaO2 of 60–70 mm Hg and an oxygen saturation by pulse oximetry (SpO2) of 92–96% Oxygen should be warmed, humidified, and delivered through an air blender Concentration should be measured with a calibrated oxygen analyzer An umbilical or peripheral arterial line should be considered in infants requiring more than 45% fraction of inspired oxygen (FIO2) by 4–6 hours of life to allow frequent blood gas determinations Noninvasive monitoring with pulse oximetry should be used Other supportive treatment includes intravenous glucose Unless infection can be ruled out, blood cultures should be obtained, and broad-spectrum antibiotics started Volume expansion (normal saline) can be given in infusions of 10 mL/kg over 30 minutes for low blood pressure, poor perfusion, and metabolic acidosis Intubation and ventilation Should be undertaken if there is respiratory failure (PaO2 < 60 mm Hg in > 60% FIO2, PaCO2 > 60 mm Hg, or repeated apnea) Peak pressures should be adequate to produce chest wall expansion and audible breath sounds (usually 18–24 cm H2O) Positive end-expiratory pressure (4–6 cm H2O) should be used Ventilation rates of 20–40 breaths/min are usually required Goal is to maintain a PaO2 of 60–70 mm Hg and a PaCO2 of 45–55 mm Hg Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.