Initial Laboratory Evaluation Of Respiratory Distress In Newborn

A newborn baby may present to the pediatric nursery with respiratory distress that is manifested by tachypnea, intercostal retractions, reduced air exchange, cyanosis, expiratory grunting and nasal flaring. These are all non specific responses to an underlying serious illness. The following tests are needed in the initial evaluation:

1. Chest Radiograph:
To determine reticular granular pattern of Respiratory distress syndrome; to determine presence of pneumothorax, cardiomegaly and any life threatening congenital anomalies.

2. Arterial Blood Gases:
To determine the severity of respiratory compromise, hypoxemia and hypercapnia and type of acidosis; the severity helps in the treatment strategy.

3. Complete Blood Count:
Hemoglobin and hematocrit to determine anemia and polycythemia; white blood cell count to determine neutropenia and underlying sepsis; platelet count and blood smear to rule out DIC.

4. Blood Culture:
To recover the potential pathogen and also helpful to start the specific treatment against the involved organism.

5. Blood Glucose:
To determine presence of hypoglycemia, which may produce or occur simultaneously with respiratory distress and if present should be treated immediately. Also sometimes patient has stress hyperglycemia .

6.Echocardiography and ECG:In the presence of a murmur, cardiomegaly, or refractory hypoxia it is important to determine any structural heart anomalies or the presence of primary pulmonary hypertension of the newborn.

After this initial evaluation and laboratory tests specific treatment is given according to the cause.