![]() ( 16)( 17)( 18) Pulmonary compliance refers to a given change in volume (ΔVolume) for every given change in pressure (ΔPressure), essentially the ability of the alveoli to fill with air under a set pressure. ![]() The newborn chest wall, composed primarily of cartilage, is more pliable, predisposing neonatal lungs to pulmonary atelectasis and decreased FRC. When balanced by the outward recoil of the chest wall, functional residual capacity (FRC) occurs at the end of expiration to prevent alveoli from collapsing. The natural elastic property of the lungs is to deflate. Pulmonary disease may incite tachypnea, especially in neonates. ( 15) Tachypnea is a compensatory mechanism for hypercarbia, hypoxemia, or acidosis (both metabolic and respiratory), ( 16) making it a common but nonspecific finding in a large variety of respiratory, cardiovascular, metabolic, or systemic diseases. Tachypnea is defined as a respiratory rate greater than 60 breaths per minute. ( 1)( 15) Normally, the newborn’s respiratory rate is 30 to 60 breaths per minute. Respiratory distress in the newborn is recognized as one or more signs of increased work of breathing, such as tachypnea, nasal flaring, chest retractions, or grunting. Therefore, it is imperative that any health care practitioner caring for newborn infants can readily recognize the signs and symptoms of respiratory distress, differentiate various causes, and initiate management strategies to prevent significant complications or death. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to respiratory failure and cardiopulmonary arrest. ![]() ( 2)( 9)( 10)( 11)( 12)( 13)( 14) However, predicting which infants will become symptomatic is not always possible before birth. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarian section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. ( 2) Certain risk factors increase the likelihood of neonatal respiratory disease. ( 1) Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity this is even higher for infants born before 34 weeks’ gestation. Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit.
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