Transient tachypnoea: new concepts on the commonest neonatal respiratory disorder

Transient tachypnoea of the neonate (TTN) is the commonest neonatal respiratory disorder, but it is quite mild and so has been the subject of relatively little academic and educational work. Recent animal studies and the introduction of new bedside monitoring techniques (e.g. quantitative lung ultrasound and electrical cardiometry) have clarified its pathogenesis. Given its high incidence, TTN is a relevant public health issue and its clinical management should be considered in an era of resource constraints. This review focuses on the latest data on TTN in terms of its pathophysiology, biology, diagnosis, imaging, therapy and cost-effectiveness, so as to optimise clinical care at the bedside. The need for a new pathophysiology-based definition of TTN is also highlighted and the available therapeutics are analysed considering the associated public health issues. This updated knowledge can help to improve the management of TTN and impact positively on its relevant public health consequences. This is particularly important since the mortality of TTN is virtually nil and so cannot be used to evaluate any clinical innovation. We also aim to give some practical guidance for the real-world clinical management of TTN and contribute to the training of neonatologists who care for TTN patients.