RT Journal
A1 Yost GC, Young PC, Buchi KF
T1 SIgnificance of grunting respirations in infants admitted to a well-baby nursery
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2001
FD March 1
VO 155
IS 3
SP 372
OP 375
DO 10.1001/archpedi.155.3.372
UL http://dx.doi.org/10.1001/archpedi.155.3.372
AB Objectives 
    (1) To determine the frequency and duration of grunting in term and near-term newborns; (2) to determine the peripartum characteristics associated with grunting; and (3) to compare the short-term outcomes of newborns with and without grunting.Design 
    Medical record review of all newborns admitted to a well-baby nursery during a 2-month period.Setting 
    University well-baby nursery for term infants, with more than 2700 deliveries annually.Main Outcome Measures 
    Frequency and duration of grunting, maternal and newborn clinical characteristics, clinical course, and length of stay.Results 
    Grunting respirations beginning during the first 4 hours of life were recorded for 81 (17.4%) of 466 newborns. Fifty-five (68%) stopped grunting within 30 minutes of birth, 69 (85%) by 1 hour, and 75 (93%) by 2 hours. More mothers of grunting infants received intrapartum antibiotics than mothers of nongrunters (33% vs 20%; P = .03). More grunting infants than nongrunters received bag and mask resuscitation (15% vs 5%; P = .01). More chest radiographs, blood cell counts, and blood cultures were ordered for grunting infants, and antibiotics were more often given to grunting than nongrunting infants (11.1% vs 4.6%; P = .04). Grunters' length of stay exceeded that of nongrunters (72 vs 55 hours; P = .01), but only 3 were transferred to a neonatal intensive care unit.Conclusions 
    All grunting infants should be carefully observed, but because nearly all otherwise healthy term or near-term infants will stop grunting and have a benign course, other interventions can be postponed for 1 or 2 hours to give the newborn a chance to stop grunting or show other signs of respiratory illness.