Pulse oximetry allows the clinician to adjust the level of oxygen support needed to maintain appropriate saturation. The characteristic findings are prominent perihilar streaking, which correlates with the engorgement of the lymphatic system with retained lung fluid, and fluid in the fissures. Patchy infiltrates also have been described. A follow-up CXR may be necessary if the clinical history suggests meconium aspiration syndrome or neonatal pneumonia. In these cases, the CXR shows persistent infiltrates.
Medical care is supportive.
As the retained lung fluid is absorbed by the infant's lymphatic system, the pulmonary status improves. Supplemental oxygen to maintain adequate arterial oxygen saturation, maintenance of thermoneutrality, and an environment of minimal stimulation are the therapies necessary for these infants. As TTN resolves, the infant's tachypnea improves, oxygen requirement decreases, and the CXR shows resolution of the perihilar streaking. Infants with TTN may have signs that last from a few hours to several days. Rarely, an infant may develop a worsening picture of respiratory distress after several days.