Therapeutic effect of inhaled budesonide in transient tachypnea of newborn: A placebo-controlled study

Main Article Content

Mohamed Shawky Elfarargy
Sally El-Sayed Abu-Risha
Reham Lotfy Younis


newborn, inhaled, budesonide, tachypnea


Transient tachypnea of the newborn (TTN) is a chest disease found in neonates. It varies from mild to severe and is accompanied by neonatal morbidity and respiratory complications. This is a prospective placebo-controlled study, identification number is TCTR20200513005, which was done in the neonatal unit of Tanta University Hospital between June 2016 and March 2018. This study comprised 100 neonates with TTN, which were divided into two groups. The first group (inhaled steroid group) consisted of 50 neonates with TTN who were exposed to inhalation of corticosteroids (budesonide 2 ml, 0.25 mg/ml suspension for nebulizer, AstraZeneca AB, Södertälje, Sweden), the first dose was administered within 6 h of birth and the second dose was given 12 h later. The second group (placebo group) consisted of 50 neonates with TTN who were exposed to placebo inhalation (2 ml of distilled sterile water). There was significant difference between both groups regarding Down score (P = 0.001), TTN clinical score (P = 0.001) and Saturation of Peripheral Oxygen (SpO2) measured by pulse oximeter (P = 0.008), while there was nonsignificant difference between both groups regarding PH (P = 0.573), and this showed that clinically the inhaled steroid group is significantly better than the placebo group. Hence, this study concludes that since administration of inhaled budesonide showed improvement in TTN cases, it could be a recommended line of treatment for neonatal TTN.

Abstract 375 | PDF Downloads 75 HTML Downloads 7 XML Downloads 0


1. Heinonen S, Süvari L, Gissler M, Pitkänen O, Andersson S, Helve O. Transient tachypnea of the new born is associated with an increased risk of hospitalization due to respiratory syncytial virus bronchiolitis. Pediatr Infect Dis J. 2019 Apr;38(4):419–21.
2. Raimondi F, Yousef N, Rodriguez Fanjul J, et al. A multicenter lung ultrasound study on transient tachypnea of the neonate. Neonatology. 2019; 115(3):263–8.
3. Ozalkaya E, Topçuoğlu S, Hafizoğlu T, Karatekin G, Ovali F. Risk factors in retained fetal lung  fluid syndrome. J Neonatal Perinatal Med.  2015;8(2):85–9.
4. Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol. 2006;30:34–43. 2006.01.006
5. Venkatesh VC, Katzberg HD.Glucocorticoid regulation of epithelial sodium channel genes in human fetal lung. Am J Physiol. 1997 Jul; 273(1 Pt 1): L227–33.
6. Delara M, Chauhan BF, Le ML, Abou-Setta AM, Zarychanski R, ‘tJong GW. Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: A systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2019 Mar;104(2): F137–44.
7. Armangil D, Yurdakok M, Korkmaz A, Yigit S, Tikinalp G. Inhaled beta-2 agonist salbutamol for the treatment of transient tachypnea of the newborn. J Pediatr. 2011;159:398–403. https://doi. org/10.1016/j.jpeds.2011.02.028
8. Riskin A, Abend-Weinger M, Riskin-Mashiah S, Kugelman A, Bader D. Cesarean section, gestational age, and transient tachypnea of the newborn: Timing is the key. Am J Perinatol. 2005;22:377–382.
9. Schuepp KG, Straub D, Moller A, Wildhaber JH. Deposition of aerosols in infants and children. J Aerosol Med. 2004;17:153–6. 10.1089/0894268041457228
10. Vaisbourd Y, Abu-Raya B, Zangen S, et al. Inhaled corticosteroids intransient tachypnea of the newborn: A randomized, placebo-controlled study. Pediatr Pulmonol. 2017 Aug;52(8): 1043–50.
11. Bassler D, Halliday HL, Plavka R, et al. The Neonatal European Study of Inhaled Steroids (NEUROSIS): An EU-funded international randomized controlled trial in preterm infants. Neonatology. 2010;97:52–5.
12. Dehdashtian M, Aletayeb M, Malakian A, Aramesh MR, Malvandi H. Clinical course in infants diagnosed with transient tachypnea of newborn: A clinical trial assessing the role of con-servative versus conventional management. J Chin Med Assoc. 2018 Feb;81(2):183–6. https://
13. Pirjani R, Afrakhteh M, Sepidarkish M, et al. ‘Elective caesarean section at 38–39 weeks gestation compared to > 39 weeks on neonatal outcomes: A prospective cohort study. BMC Preg Childbirth. 2018 May 8;18(1):140. https://doi. org/10.1186/s12884-018-1785-2
14. Prefumo F, Ferrazzi E, Di Tommaso M, et al. Neonatal morbidity after cesarean section before labor at 34(+0) to 38(+6) weeks: A cohort study. J Matern Fetal Neonatal Med. 2016;29(8):1334–8. 67058.2015.1047758
15. Ozden Omaygenc D, Dogu T, Omaygenc MO, et al. Type of anesthesia affects neonatal well-being and frequency of transient tachypnea in elective cesarean sections. J Matern Fetal Neonatal Med. 2015 Mar;28(5):568–72. 4767058.2014.926328
16. Dani C, Reali MF, Bertini G, et al. Risk factors for the development of respiratory distress syndrome and transient tachypnea in newborn infants. Italian Group of Neonatal Pneumol. Eur Respir J.1999 Jul;14(1):155–9. 1034/j.1399-3003.1999.14a26.x
17. Li B, Han S, Liu F, Kang L, Xv C. Budesonide nebulization in the treatment of neonatal ventila-tor-associated pneumonia. Pak J Med Sci. 2017 Jul–Aug;33(4):997–1001. 12669/pjms.334.12907
18. Clouse BJ, Jadcherla SR, Slaughter JL. Systematic review of inhaled bronchodilator and corticoste-roid therapies in infants with bronchopulmonary dysplasia: Implications and future directions. PLoS One. 2016;11(2):e0148188. https://doi. org/10.1371/journal.pone.0148188
19. Mokra D, Drgova A, Kopincova J, Pullmann R, Calkovska A. Anti-inflammatory treatment in dysfunction of pulmonary surfactant in meconi-um-induced acute lung injury. Adv Exp Med Biol. 2013;756:189–96. 978-94-007-4549-0_24
20. Taniguchi A, Hayakawa M, Matsusawa M, Hayashi S. Inhaled procaterol for the treatment of transient tachypnea of the newborn. Pediatr Int. 2018 Nov;60(11):1014–19. ped.13699
21. Malakian A, Dehdashtian M, Aramesh MR, Aletayeb MH, Heidari S. The effect of inhaled salbutamol on the outcomes of transient tachypnea of the newborn. J Chin Med Assoc. 2018 Nov;81(11):990–7.
22. Kahvecioğlu D, Çakır U, Yıldız D, et al. Transient tachypnea of the newborn: Are there bedside clues for predicting the need of ventilation support? Turk J Pediatr. 2016;58(4):400–405. https://
23. Hirata K, Nozaki M, Mochizuki N, Hirano S, Wada K. Impact of time to neonatal transport on outcomes of transient tachypnea of the newborn. Am J Perinatol. 2019 Aug;36(10):1090– 1096.