Atypical acute respiratory disorder in late preterm and term newborn infants.

OBJECTIVE: We were to describe the clinical characteristics of late preterm and term newborn infants who needed invasive or non-invasive ventilation for respiratory distress but did not meet the diagnostic criteria of common neonatal respiratory disorders (atypical acute respiratory disorder; aRD).

METHODS: We retrospectively reviewed electronic medical records of 242 late preterm and term newborn infants born who were admitted to the neonatal intensive care unit for acute respiratory distress developed within 24 h after birth.

RESULTS: Newborn infants with aRD had significantly higher mean, maximum blood PCO2 levels and maximum FiO2 levels during the first 72 h after birth than infants with transient tachypnea of the newborn (TTN). Total periods of oxygen supplementation of the infants with aRD were significantly longer than those of infants with TTN, but shorter than those of the infants with meconium aspiration syndrome (MAS).

CONCLUSIONS: Except for definite diagnosis, higher oxygen need and PCO2 level on blood gas analysis during the initial period of their respiratory illness may be able to predict aRD, and these interventions may be able to decrease neonatal respiratory morbidity.