Rethinking Neonatal Transient Tachypnoea Of Newborn Management: Efficacy And Safety Of Fluid Restriction In A Randomized Study

Abstract

Structured abstract: Background Transient Tachypnoea of the Newborn (TTN) is a self-limited respiratory condition resulting from delayed clearance of fetal lung fluid. Excess fluid administration may worsen pulmonary edema. This study evaluated whether fluid restriction improves clinical outcomes in neonates with TTN.

Objective To determine whether fluid restriction reduces respiratory support requirements and hospital stay in neonates with TTN.

Methods (design, setting, participants, interventions, outcomes, timeframe)

Design: Randomized controlled trial.

Setting: Neonatal unit at a tertiary care center.

Participants: Neonates diagnosed with TTN.

Interventions: Restricted Group (RG) vs Standard Group (SG) for fluid management.

Outcomes: Primary—duration of oxygen therapy, progression of Downes score, need for non-invasive ventilation (NIV), and length of hospital stay.

Timeframe: From birth to hospital discharge.

Results (outcomes with p value)

Baseline characteristics showed no significant differences between groups: birth weight (p = 0.283), gestational age (p = 0.889), sex distribution (p = 0.250), cesarean delivery (p = 0.380), antenatal steroid coverage (p = 1.000). Progression of respiratory distress (p = 0.633), duration of oxygen therapy (p = 0.072), and NIV requirement (p = 1.000) were similar between groups. Hospital stay was significantly shorter in the RG (4.68 ± 1.03 days) compared with the SG (5.84 ± 1.38 days; p = 0.001).

Conclusions Restricting fluid intake in neonates with TTN may not significantly alter short-term respiratory interventions but appears to reduce hospital stay, likely through enhanced pulmonary fluid clearance. Other outcome measures do not consistently support routine restrictive fluid strategies in TTN management.

Trial status Completed.