الفهرس 
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Abstract
Respiratory distress is one of the most major causes of morbidity and mortality in the neonatal period. Early detection and management is considered crucial for physicians working in the neonatal intensive care units. Most common causes of neonatal respiratory distress are transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome and congenital pneumonia. Clinical features of neonatal respiratory distress are tachypnea (respiratory rate > 60 breath per minute), nasal flaring, chest wall retractions, grunting and cyanosis. Diagnosis of neonatal respiratory distress is based mainly on history, clinical examination and radiological imaging. Due to similarity of clinical presentations in most of the causes of neonatal respiratory distress and similarity of chest X-ray findings in most of them, it was found to be difficult to distinguish the main cause of neonatal respiratory distress, x-ray chest has also hazards of harmful and undesirable exposure to ionizing radiation. Our study is a cohort prospective study designed to compare thoracic fluid content in neonates with transient tachypnea of newborn and other causes of respiratory distress over the first 48 hours. This study involved 105 cases divided into 3 groups (TTN respiratory distress group, Non-TTN respiratory distress group, Control group)
Our study showed significantly higher male participants and use of steroids in both RD groups vs. control group. Delivery room resuscitation was required in all RD groups vs. 28.6% cases in control group. It also shows that gestational age was significantly higher in control group vs. RD groups, birth weight was significantly lower in TTN group vs. non TTN and control groups, parity was significantly higher in TTN group vs. non TTN and control groups and APGAR score was significantly higher in control group vs. RD groups. As regards grunting and positive CRP were significantly higher in non-TTN vs. TTN group. None of cases in TTN group has cyanosis while all cases in non-TTN have. None of cases in TTN group has abnormal CXR while nearly all cases (97.1%) in non-TTN have. Tachypnea and retractions decreased significantly over time in TTN Vs. non- TTN group. TTN cases with grunting was 68% at 6-hours and none of cases remained with grunting at 24- and 48-hours while the proportions of non-TTN cases with grunting decreased significantly over time. None of the TTN cases had cyanosis while all non-TTN cases had cyanosis at 6-hours and this proportion decreased significantly at 24- and 48-hours. Conclusion: ICON is a noninvasive tool which can be used in conjunction with clinical parameters and CXR as a tool for differentiation between TTN and other causes of respiratory distress within first 24-hours of life by using cutoff value of TFC at 24-hours and TFC drop-rate. This will allow earlier and optimum management of different causes of respiratory distress.