Transient Tachypnea of the Newborn - TTN - Tala Talks NICU

[@alkafernandez29]

Dear Dr Tala, I am working in Himalayas. It's a remote place in India, where there are no neonatologists. I am a Pediatrician but have been looking after newborns too. You are a wonderful teacher. Love to listen to you. Thank you so very much for sharing your knowledge so succinctly.

[@TalaTalksNICU]

Wow! The Himalayas! Thank you so much for taking care of the babies- it must be so difficult to be in a remote area- we're sure you're doing SO much stuff by yourself. Really impressive!!! We're so glad these videos help at all! Thank you for writing in!

[@alospm]

I’m enjoying your videos so much! I’ve been a NICU nurse for many years but recently returned to work after having my own babies and your videos are a great refresher!

[@TalaTalksNICU]

Congratulations Alison on your babies and your (hopefully extended) maternity leave! Always weird coming back after babies! We're so happy that these are working as a good refresher. We hope you get all the satisfaction you want at work to make it worth being away from your own babies :)

[@monicabenay9177]

Dear dr. Tala I really appreciate your work!!!!! I´'m a neonatologist from Argentina I'm learning English because I've a job offert abroad so your videos are very useful for me. Thank you so much!!

[@TalaTalksNICU]

Hello Dr. Benay- so happy you're watching and the language is helping!! Congratulations on your new job too- such an exciting part of life!!!

[@pgrodriguez88]

I’m loving your videos!!!! I’m a Pediatric Intensivist attending, working in a Ecuadorian Amazonian hospital, in a small NICU (NOT MY THING)..It’s been a great challenge, but, your videos had been of great help..GREAT JOB!!! THANK YOU VERY MUCH!!

[@TalaTalksNICU]

Well you sound like a complete hero! What an amazing experience you must be having. We're so happy these videos help at all! Thank you so much for taking the time to write :)

[@something93565]

The only thing that can make this better is the subtitles. Thank you so much, Dr. Tala!

[@TalaTalksNICU]

Hello! Yes! We have had a few requests for subtitles/ a PDF version/ printable bullet points etc. We are discussing these options. It's all so much more time-consuming than we initially assumed, so for now, we're concerned that it will delay getting videos out! I promise we'll get it done eventually!

[@something93565]

@@TalaTalksNICU Thank you so much!

[@santhisri3520]

I've been a NICU nurse in Tamilnadu . thank you so much mam for your videos

[@TalaTalksNICU]

Thank you so much for being here! Glad you’re finding these helpful!

[@azizjunaid3708]

Very clear and direct to the point- well explained thanks doctor

[@TalaTalksNICU]

Thank you for the lovely compliment and for taking the time to write

[@kyleFed]

I love your videos. I’m a new grad NICU nurse and I am learning so much more with your videos! Thanks :)

[@TalaTalksNICU]

Hi Kyle! We're so glad you found us! And congrats on your new job- we're sure you'll love it! Let us know what would new videos would be helpful for you?! Thanks!!

[@thembiq6598]

You’re such an amazing tutor

[@TalaTalksNICU]

You are so kind Themby. Thank you for watching all of these!

[@rehammhmd8538]

tala i love u ,u reall helps me understanding my career please don't stop

[@TalaTalksNICU]

That makes us SO happy. We have no plans of stopping- in fact we have so many lectures we plan to give- we wish we had more time!! Thanks so much for your comment!

[@bwalyatubi6814]

Beautiful....thank you! Please keep them coming

[@TalaTalksNICU]

Thanks so much Bwalya- that is definitely our plan!

[@alexmabiria7112]

What a nice explanation.TTN made simple.

[@TalaTalksNICU]

That's what we're aiming for Alex! So thank you so much for your comment!

[@sifnamoljoseph85]

Very informative videos ,as a nicu nurse very clearly understanding....Thank you so much for your each videos.Please continue to upload more videos

[@TalaTalksNICU]

We’re so happy you find these clear! We’re definitely planning on continuing putting out videos for some time!!

[@sammartial4927]

Great video! Straight to the point and very informative. Could you please explain further how the grunting stents the airway? Thank you.

[@TalaTalksNICU]

Hi Sam- thanks for the compliments :) Grunting is where the glottis suddenly closes in an attempt to 'trap' the air and maintain the FRC- so kind of like the infant trying to give themselves CPAP. Does that make sense?

[@sammartial4927]

@@TalaTalksNICU Yes it does. Thanks a lot

[@digimolraphel25]

Hi Dr Tala ...Amazing presentation

[@TalaTalksNICU]

Thank you so much for watching

[@khairyelwerfeli]

So sweet Dr Tala ❤

[@TalaTalksNICU]

Hahaha! I’ll take it :)

[@BrandonioTNL]

My son was born via C section at 5:01 this morning. He has fluid in his lungs. The doctors said he is improving. He was doing the "grunting" mentioned in this video.

[@TalaTalksNICU]

Congratulations!!!! It is very common- hopefully he’ll be improving soon xx

[@irfanakhtar3990]

How much time i will take to fully recover, if baby is doing grunting.????

[@Marilynefc]

I love the fun charismatic personality!

[@TalaTalksNICU]

Thank you so much Mari A!

[@something93565]

Excellent! Thank you so very much!

[@TalaTalksNICU]

Thank you so much Lorina. We really appreciate your support :)

[@decembergirl748]

Amazing explanation as always Dr. Tala! Thank you 🙌🙌🙌

[@TalaTalksNICU]

Thank you so much for your lovely comment! (Also love your handle!)

[@elishatushabomwe1344]

Its been so nice surely. God bless you

[@TalaTalksNICU]

Thank you so much for taking the time to comment :)

[@dipikadave7533]

Thank you Tala your vedio is very informative.Being a nurse is very helpful for me

[@TalaTalksNICU]

Hello! We're so glad you find these videos helpful. Thanks so much for letting us know :)

[@mohamadxalil-i1h]

Amazing ❤

[@markoswodaje2385]

It's best lectures ....

[@TalaTalksNICU]

Thank you so much for watching Markos

[@leanne3862]

I should be paying you.. thank you so much for explaining these concepts so well!

[@TalaTalksNICU]

That's so sweet! Thanks so much Leanne!

[@antohalleyano5467]

Thank you so much for this video. Really explanative. I don't get this detailed explanation from the hospital 🙏

[@TalaTalksNICU]

We're so glad it helped! Thank you for watching and commenting :)

[@kebedealemu8859]

Love your videos on NICU

[@TalaTalksNICU]

Thank you so much for watching!

[@kimakira2362]

Dr.Tala , do you have a podcast? your videos helps a lot!! thank you!

[@TalaTalksNICU]

Hello! No we don’t! Although Arianna and I keep talking about one!! We’re so busy with this channel low! So glad they are helpful to you!!

[@kengurukashanice76]

You are the best!

[@TalaTalksNICU]

Thank you so much for your positivity!

[@Roger-hu4tk]

Thank you so much much appreciated

[@TalaTalksNICU]

Thank you for watching and for the positive reinforcement!

[@crystalumar9423]

Thanks for this brief but concise video...came across your channel by chance and happy I did. Looking forward to future videos :)

[@TalaTalksNICU]

We're so happy you're here and part of the NICU community. We have a back-log of requests now we're trying to get through- but please let us know if there's anything in particular you'd like us to discuss!

[@marielenaguzman6305]

Hi Dr. Tala can you make a video on when to use nasal cannula, hfnc and cpap.

[@TalaTalksNICU]

Hello Marielena! We're so glad you asked for this- because we actually have a couple of videos planned on exactly this topic in the near future. Thanks so much for watching and for commenting :)

[@alkafernandez29]

Dear Dr Tala, please take a lecture on LMA.

[@TalaTalksNICU]

Yes- we need to do this- especially as we feel that these are probably going to be used more and more in the NICU. Honestly though- as a team- we have only used LMAs in circulation. I would recommend you watching this excellent video: kzbin.info/www/bejne/bmjJnXZ5js1-kJo Hope thus helps!!

[@yahyahassan4246]

Thank you so much. Much appreciated all your series. Thnk you..

[@TalaTalksNICU]

We're loving your loyalty, Dr. Hassan!

[@mans12341000]

Simplified and nicely explained . I become fan of your teaching skills. It's really refreshing basic topic within few minutes. Hats off to you . Can you make video on central line cannulation in newborns . Thank you so much.

[@TalaTalksNICU]

Hello Manoj! Thanks for watching and for commenting- these messages keep us going! We have been wanting to do a series on procedures since we started but we need to figure out how to do it in the NICU by going down the proper channels!!! Stay tuned!!

[@mary556-s6z]

Thank you for these wonderful lectures, Dr. Tala Can you add videos of birth asphyxia and neonatal pneumonia

[@TalaTalksNICU]

Hello! Thanks so much for watching! We do need to do a video on neonatal pneumonia (thank you! this wasn't on our list!). We promise we'll get to it! We recorded a video on HIE already- if you go to the search engine on the channel's page you'll find it??

[@shimma4996]

Great video! I am having some trouble understanding the difference between TTN and PPHTN...it seems that both involve extra fluid remaining in the lungs but what is the difference?

[@TalaTalksNICU]

TTN is retained fetal lung fluid. PPHN is high pressure in lungs from the blood vessels not relaxing because something else is going on (e.g RDS, MAS, pneumonia etc.). If TTN is really bad and not treated adequately, it can result in increased pulmonary pressures. Hope this helps!

[@suhailfarooq2552]

Thankyou for the information

[@TalaTalksNICU]

Hope you found it helpful :)

[@meor5175]

Amazing intro to TTN! Next topic suggestion. How about neonatal jaundice?

[@TalaTalksNICU]

Thank you so much Myo! And you're in luck- hyperbilirubinemia will be covered in the next few videos we put out :)

[@johnsunn1256]

Since birth (30+6 planned c-section, preemclampsia/gestational diabetes), baby started with cpap on 21% room air. Now switched to vapotherm 3liters (tried 2liters for a day and went back up) 21% room air and has random respiratory rates that go low to high (still breathing too fast for direct feeding). We're at day 21 of life. If not TTN is it just development most likely? Every other milestone has been reached. Weight (born 3lbs 4.6 oz, now 4lbs 3 oz) maintaining body temp, feedings cues etc. Just monitoring breathing now. Whats your take?

[@TalaTalksNICU]

Hello! Normally TTN lasts 2-3 days so if beyond that period then it’s something else. Here it definitely sounds like some pulmonary insufficiency of prematurity- ie developmental stuff. Sounds like little one is doing well :)

[@pang4617]

Amazing. I have learned a lot

[@TalaTalksNICU]

Thanks so much Pa- for watching and for commenting :)

[@adeelrajpoot6792]

Fantastic Dr

[@TalaTalksNICU]

Thank you so much for watching Adeel :)

[@mashudumuvhali2338]

Great tutor😘

[@TalaTalksNICU]

Thank you!!!! A lovely compliment!

[@megandeveraux9842]

If a newborn started out with tachypnea, nasal flaring and maybe a little grunting. Spo2 is slightly low for minutes old what is your normal practice? If SVD is it appropriate to just give a little blow by on mom and keep skin to skin to keep spo2 within range? Would it be best to support with CPAP thus take off of Mom? Do you ever drop a OG right after delivery if they sound especially wet just to clear fluids out of their stomach? 😊

[@TalaTalksNICU]

Oooh this happens so often doesn’t it! I think so much depends on what baby looks like and what direction he is going in. Really tugging and grunting getting worse? Maybe Cpap. A bit cyanotic but breathing improving- maybe NC. Mild desats and comfortable then I’d wait!!! Not v helpful!

[@mohamedelsheity1242]

😂😂you and your smile are the best. thank you

[@TalaTalksNICU]

Ha! Thank you! Appreciate you being here :)

[@0819superman]

Excellent!

[@TalaTalksNICU]

Thanks so much for watching for taking the time to comment!

[@Monica_29]

3:15 Why does an infant of a diabetic mother have increased risk of TTN? Learning so much from your videos from a Physiotherapist's perspective. Thank you!

[@TalaTalksNICU]

Hello Monica- this is an excellent question- and one which I'm not sure of the answer. Infant of diabetic mothers have decreased surfactant production so they also have a higher chance of RDS. I'm not sure if a higher circulating glucose also affects the channels that are responsible for absorbing the fluid from within the lungs? Some (but not all) of the effect maybe that IDMs are also larger and more likely to be delivered by C-section. I will try to research more and get back to you if I find something! Thank you for watching and commenting :)

[@Monica_29]

@@TalaTalksNICU That all makes much sense. I didnt expect such a thorough answer. Thank you!

[@velayudhankottamal6545]

Plzz do a video about CPAP functioning And it's mechanism

[@TalaTalksNICU]

Absolutely. We'll be starting a vent 101 series of videos soon explaining different modes of ventilation and gases etc. Will be sure to included CPAP too. Thank you for watching and commenting!

[@mohammeddeeq2178]

Wooow wooow thank you. Soo much 🙏🙏

[@TalaTalksNICU]

Love this comment! Thank you so much for watching!

[@Mgan19]

Please do a video about newborn jaundice, I LOOVE YOUR CHANNEL

[@TalaTalksNICU]

Yes! We have a series of these planned. I love talking about hyperbilirubinemia! Thank you for watching and commenting!

[@thembiq6598]

Yes please Jaundice

[@BlueSky-wn2ox]

Thanks alot what an informative explanation🌸

[@TalaTalksNICU]

Thank you so much for watching and commenting!

[@amberhughes7754]

What does it mean if a baby born 29 weeks 5 days currently in the nicu and has tachynea only during feeds? My baby is 40 weeks and 4 days and she is having this problem.

[@TalaTalksNICU]

Congratulations! Obviously I don't know the details- but generally this is one of two issues: 1) Eating itself takes a lot of stamina and strength so it's possible your baby is tiring out during feeds or 2) your baby is micro aspirating during feeds (which means small amounts of the milk are going down the breathing tube or trachea instead of down the esophagus (tube to stomach). Many ex-preemies do this and generally grow out of it. I'm sure the speech therapist and NICU team at your NICU are looking into both these scenarios. Good luck!

[@donellesatchwell494]

Amazing!

[@TalaTalksNICU]

Thank you!!

[@missyrinehart5159]

This is amazing! Could you please do BPD?

[@TalaTalksNICU]

Hello Missy! Thanks so much- yes! we are doing BPD soon, we promise!

[@naveedhaider3112]

Loved those giggles. :)

[@TalaTalksNICU]

Ha! Justin always makes me laugh!

[@Mohammedkhalaf-vm6xj]

ازاي نفصل طفل من جهاز التنفس الصناعي ونتفادي مشاكل جهاز التنفس الصناعي أتمني الشرح شكرا

[@TalaTalksNICU]

This is the translation I got: How could we cease artificial breathing from a baby and avoid any problems doing this. Thank you for explaining. Well eventually babies get older and stronger and their events are not as bad. Initially if they’re not breathing they need to be on the ventilator.

[@ramdhassanap8271]

Nice information mam

[@TalaTalksNICU]

Thank you so much for watching!

[@Noreem100]

Hi this is Noreem I work in NICU recently in Saudi Arabia , want to ask you wen to use Nitric Oxide and what is the purpose of using it with mechanical support .Thanks

[@TalaTalksNICU]

Hello Noreem! Thank you so much for watching and commenting. We discuss iNO in the pulmonary HTN video- take a look at that- and if you still have questions, I'll be sure to answer them!!

[@rajkoladia2055]

Nice explanation 👌

[@TalaTalksNICU]

Thanks so much Raj!

[@asimanrostami]

excellent 👌❤

[@TalaTalksNICU]

Thanks so much Asma!

[@trinhjavaid2344]

Can you make a video regarding chest tubes? Inserting, placing, negative pressure etc?:)

[@TalaTalksNICU]

Hello Trinh! First lovely picture! We think we have a suitable simulator for it-so we now have a plan at least for how to film it!! Thanks for your suggestion!

[@trinhjavaid2344]

@@TalaTalksNICU :) thank you! Sorry a couple more cause I’m in the NNP Program! Would you add needle aspiration with it? And if I think of more I’ll be sure to send a message!

[@TalaTalksNICU]

Absolutely! Great idea!! Thanks!

[@c_fairyland]

Please make avedii on hhhfnc

[@TalaTalksNICU]

Love it when this happens! We already made one- check out the home page :)

[@jampellhendrup1376]

What's the difference between birth asphyxia and TTN

[@TalaTalksNICU]

Hello Jampel! Birth asphyxia means that the baby lacked Oxygen during the delivery process (see the HIE video we filmed). TTN is when the fluid that was in the lungs all the way through pregnancy- hasn't completely emptied out of the lungs yet-and so they're 'wet'. Does this answer your question? Thanks so much for subscribing :)

[@fatem6144]

If it sever they use NO , can you explain that

[@TalaTalksNICU]

Great question. Rarely TTN is treated way too late and not aggressively enough- and the lungs go into worsening pulmonary HTN- which needs something big to get out of it. This is very rare- and would normally be associated with another underlying issue (e.g. pneumonia, hypolasia etc).

[@klalawmpuia2001]

Nicely said

[@TalaTalksNICU]

Thanks so much!!!

[@chemutaiharonelites8803]

Good job

[@TalaTalksNICU]

We really appreciate you watching and taking the time to comment, Chemutai :)

[@shasy00]

its the day 7 baby in nicu. All clinical tests are done but nothing found. (Chest cray, echo, stomach and head ultra sound, blood tests for any infections) baby breathing rate varies between 60-75. Baby looks so much fine, breastfed well. What could it be then?

[@shasy00]

yes its a selective c section due to GD

[@TalaTalksNICU]

Obviously we don't know enough about the case to offer any advice- but if a baby is breast feeding well, then that's very reassuring. Good luck!

[@blessingskaimbo6479]

Thanks 😊❤️

[@TalaTalksNICU]

Thank you for being here!

[@osamaalagamawy3891]

ما شاء اللة. بارك اللة فيكم.

[@TalaTalksNICU]

Shukran baad marra!

[@charmainedivinagracia4064]

So the only difference between RDS and TTN is the time it manifests? like they have the same signs and symptoms (grunting, retractions, tachypnea). I remember RDS is due to a deficient surfactant. TTN is retained fluid in the lungs. (sorry im just listing out possible differences that i could remember. dont hesitate to correct me please. I want to learn hehe) both resolves in 3 days?

[@TalaTalksNICU]

Hello Charmaine! You're right- from a purely physical exam standpoint, it would be difficult to differentiate the two (tachypnea, grunting, retractions etc). Generally RDS occurs in earlier GAs, and TTN in later. RDS is more likely to need an Oxygen requirement, whereas TTN is often the grunting babies needing CPAP but like 23% fi02. Generally TTN resolves in 3 days (it's transient!) but RDS normally lingers on much longer (weeks to months depending on the gestational age). Does this help?

[@charmainedivinagracia4064]

@@TalaTalksNICU yes it does!!! thankyou! 😌😌 Thankyou for the videos. Very easy to comprehend ☺️

[@TalaTalksNICU]

Great! Thanks for being here :)

[@melissahall7009]

Thank you

[@TalaTalksNICU]

Thank you for watching!

[@peddagorantlagarimanohar1525]

What is the difference between asphyxia and respiratory failure

[@TalaTalksNICU]

Asphyxia means the body is not getting the Oxygen it needs (e.g. during choking when the airways are blocked), whereas respiratory failure means the lungs themselves are failing and unable to do the job of breathing (getting Oxygen from alveoli into the blood vessels and getting carbon dioxide out f the body) . Hope this makes sense?

[@peddagorantlagarimanohar1525]

@@TalaTalksNICU Why are hyaline membranes formed in the alveoli during RDS, but not during pneumonia? CPAP and expiratory grunting. What do they have in common? The difference in the mechanism of action and indications for high-frequency oscillatory ventilation and the usual mode of invasive ventilation in newborn? Can we put Respiratory distress syndrome as diagnosis?

[@ginagardiner9186]

Love it

[@TalaTalksNICU]

Great! Thanks for being here :)

[@dsolowkeyx2823]

My son is 6 days old and is nicu because of this problem when I call they tell me his still breathing fast but when I look it up it only says it last about 3 days so what really is going on?

[@TalaTalksNICU]

Hello. We're sorry it took us so long to reply- hopefully your son is doing much better now. Congratulations on his birth!

[@shreyaroy8711]

My baby is there in Nicu for 5days..i hd Gestational Diabetes and was delivered in 38week 3days

[@TalaTalksNICU]

Thank you for sharing Shreya. I hope your baby is much better now. Congratulations!

[@hashimkhan9218]

Hi Doc, my baby has been ion CPAP since 5th hour of his life in NICU, retractions are very much visible. blood group of mum and baby are different. is there a concern ???

[@TalaTalksNICU]

Hello Hashim. Congratulations on your new baby. If it is TTN, it can take 2-3 days for the retractions and tachypnea to go away. Many babies have different blood types from their mothers. Your doctors will be following the levels. Good luck!

[@ravigangawat3550]

Mam my son was born via. Normal delivery,but dr said that he takes fluid inside it ...and today after 12 days he is still in icu... Dr says that there is symptoms of techeapenia ..

[@ravigangawat3550]

What we do... Any suggestions..??

[@ravigangawat3550]

They said in x ray ,,spot are there...

[@TalaTalksNICU]

Congratulations on your son! Hopefully he continues to heal every day. Sometimes after babies need some respiratory support it takes time for them to eat. We wish him health and you peace xx

[@ssmm8200]

can ttn make baby needs mechanical ventilation?

[@TalaTalksNICU]

Excellent question. If a baby has pure TTN, it would be unlikely the infant would need to be intubated and on a vent, unless it had reached the point of pulmonary hypertension or if for example the infant blew a pneumothorax (e.g. from being on the CPAP). Pure TTN usually needs low, if any extra Oxygen, and normally they're breathing enough by themselves to ventilate adequately too. Thanks for the question and for being here with us!

[@talabatbouta]

Great video thank you!

[@TalaTalksNICU]

Great name! Thanks for watching and commenting!

[@rehabhh5834]

How to calculate TpN for neonate

[@TalaTalksNICU]

we can definitely go over this!

[@عبداللهحسين-ق6خ]

thanks

[@TalaTalksNICU]

Thank you for watching!

[@salwaalmawy8190]

Piano players🤣

[@TalaTalksNICU]

HAHA! right?

[@Kirito-xi5od]

Dr. Tala, I appreciate the length you go to teach a complicated lesson into a simple one. You make learning fun.

[@TalaTalksNICU]

AHHH that's lovely! Always our aim to simplify lessons as much as possible. And making anything fun is a massive bonus, because it keeps people wanting to learn more :) Thank you!

[@olabadwey9022]

Thank you

[@TalaTalksNICU]

You're welcome!!!!