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Neonatal respiratory disorders account for most admissions to intensive care units in the immediate newborn period. Newborns in respiratory distress must be evaluated promptly and accurately; occasionally, neonatal respiratory distress is life-threatening and requires immediate intervention. The causes of respiratory distress in the newborn are numerous and are due to pulmonary or nonpulmonary processes. (1) Initial stabilization of the neonate, through management of the airway, breathing, and circulation, takes precedence over determining the cause. A thorough initial assessment, including maternal and neonatal history, physical examination, and appropriate use of diagnostic tests, is essential to diagnosing the cause of respiratory distress.

Respiratory distress in the neonate most commonly presents as one or all of the following physical signs: tachypnea, grunting, nasal flaring, retractions, and cyanosis. (2) A normal respiratory rate in a newborn is between 30 and 60...

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