Defination

• Transient tachypnea of the newborn (TTN) is a benign, self-limited

condition that can present in infants of any gestational age shortly
after birth.
• It is caused by a delay in the clearance of fetal lung fluid after birth,
which leads to ineffective gas exchange, respiratory distress, and
tachypnea.
•  it often poses a significant, diagnostic dilemma in the care of
newborn babies with respiratory distress.
 Pathophysiology

• Fetal Lung
• The fetal pulmonary epithelium secretes alveolar fluid at around 6 weeks of
gestation.
• Chloride ions in the interstitium enter the pulmonary epithelial cell through
the active transport of sodium, potassium, and chloride into cells (Na-K-2Cl
transporter) which, in turn, are secreted into the alveolus through various
chloride channels.
• Sodium follows the chloride ions through para-cellular pathways, and water
is transported across the cells via aquaporin.
• Volume of fetal lung is maintained by the larynx, which acts as a one-way
valve, allowing only outflow of fluid.
 Pathophysiology
• Neonatal Lung
• Passive movement of sodium through epithelial sodium channels (ENaC) is
believed to be the principle mechanism of reabsorption of fetal lung fluid
with starling forces and thoracic squeeze playing a minor role in clearance.
• With the onset of labor, maternal epinephrine, and glucocorticoids
activate the ENaC on the apical membranes of type II pneumocytes.
• Sodium in the alveolus is transported passively across the ENaC proteins
which in turn is actively transported back to the interstitium by the
Na+/K+-ATPase pump.
• An osmotic gradient is created which allows chloride and water to follow
and be absorbed into pulmonary circulation and lymphatics.