ABSTRACT
Respiratory distress is characterized by tachypnoea (respiratory rate >60 per minute), expiratory grunting and recession. Cyanosis without oxygen is common. About 2% of all babies and 20% of those under 2500 g have breathing difficulties in the neonatal period. The commonest pulmonary causes of respiratory distress are respiratory distress syndrome (RDS), transient tachypnoea of the newborn, streptococcal pneumonia and meconium aspiration. RDS is due to surfactant deficiency and affects about 7000 UK babies each year. Improvements in neonatal intensive care, including the use of surfactant replacement therapy, have significantly reduced the mortality. The differential diagnosis of a cyanosed baby includes lung disease, cyanotic heart disease and persistent fetal circulation.
