---
title: "Reducing NICU Length of Stay and Interventions for Transient Tachypnea of the Newborn"
id: "pubmed-42843824"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42843824"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42843824/"
doi: "10.1542/peds.2025-075231"
published_at: "2026-10-08T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Reducing NICU Length of Stay and Interventions for Transient Tachypnea of the Newborn
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42843824
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42843824/)
- **DOI:** [10.1542/peds.2025-075231](https://doi.org/10.1542%2Fpeds.2025-075231)
- **Published At:** 2026-10-08T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This quality-improvement initiative targeted infants with **Transient tachypnea of the newborn (TTN)** admitted to level III and IV NICUs to reduce unnecessary interventions and shorten NICU length of stay (LOS). - The team used the **Model for Improvement** and applied interventions including consensus data review, a **clinical guideline**, case audits, and an **EMR order set**. - Inclusion criteria were neonates born at 35 weeks' gestation or later with a diagnosis of TTN. - The primary outcome was **NICU LOS**; secondary outcomes included time to first feed, time on respiratory support, peripheral IV (PIV) placement, intravenous fluid (IVF) use, hyponatremia, number of blood draws, and same-day birth parent–baby discharges. - Balancing measures were NICU readmissions, percentage with hypoglycemia, and exposure to breast milk during hospitalization. - After interventions, median LOS decreased from 90 hours to 51 hours. - Time to first feed and time on respiratory support decreased; incidence of hyponatremia, PIV placement, and IVF administration also decreased. - The proportion of infants discharged home with their birth parent on the same day increased. - No adverse change was observed in balancing measures (NICU readmissions, hypoglycemia rates, or breast milk exposure). - The authors conclude that standardizing care through guideline development, audits, and EMR implementation reduced LOS and medical interventions for infants with TTN in their NICUs.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Reducing Intervention and Length of Stay for Neonates With Transient Tachypnea of the Newborn [Sushma Krishna](https://pubmed.ncbi.nlm.nih.gov/?term=Krishna+S&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Richelle Reinhart](https://pubmed.ncbi.nlm.nih.gov/?term=Reinhart+R&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Malorie Meshkati](https://pubmed.ncbi.nlm.nih.gov/?term=Meshkati+M&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Brittany Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+B&cauthor_id=42843824)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-2 "Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York."), [Vidhya Venkatesan](https://pubmed.ncbi.nlm.nih.gov/?term=Venkatesan+V&cauthor_id=42843824)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-2 "Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York."), [Courtney Juliano](https://pubmed.ncbi.nlm.nih.gov/?term=Juliano+C&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#full-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.") Affiliations Expand ### Affiliations * 1 Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. * 2 Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York. * PMID: **42843824** * DOI: [ 10.1542/peds.2025-075231 ](https://doi.org/10.1542/peds.2025-075231) Item in Clipboard # Reducing Intervention and Length of Stay for Neonates With Transient Tachypnea of the Newborn Sushma Krishna et al. Pediatrics. 2026. Show details Display options Display options Format Abstract PubMed PMID Pediatrics Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pediatrics%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Pediatrics%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42843824/) . 2026 Oct 8:e2025075231. doi: 10.1542/peds.2025-075231. Online ahead of print. ### Authors [Sushma Krishna](https://pubmed.ncbi.nlm.nih.gov/?term=Krishna+S&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Richelle Reinhart](https://pubmed.ncbi.nlm.nih.gov/?term=Reinhart+R&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Malorie Meshkati](https://pubmed.ncbi.nlm.nih.gov/?term=Meshkati+M&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."), [Brittany Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+B&cauthor_id=42843824)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-2 "Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York."), [Vidhya Venkatesan](https://pubmed.ncbi.nlm.nih.gov/?term=Venkatesan+V&cauthor_id=42843824)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-2 "Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York."), [Courtney Juliano](https://pubmed.ncbi.nlm.nih.gov/?term=Juliano+C&cauthor_id=42843824)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42843824/#short-view-affiliation-1 "Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.") ### Affiliations * 1 Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. * 2 Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Hospital, New York, New York. * PMID: **42843824** * DOI: [ 10.1542/peds.2025-075231 ](https://doi.org/10.1542/peds.2025-075231) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Background and objective:** Transient tachypnea of the newborn (TTN) is a common respiratory disorder affecting late-preterm and term infants. Newborns with TTN are typically admitted to the neonatal intensive care unit (NICU) for medical care. Our objective was to reduce NICU length of stay (LOS) for patients with TTN by standardizing care to limit unnecessary intervention. **Methods:** We used the Model for Improvement to implement interventions in our level III and IV NICUs and analyzed data using control charts. Interventions included consensus development/data review, clinical practice guideline implementation, case audits, and an electronic medical record (EMR) order set. Infants aged 35 weeks or more with TTN were included. The primary outcome measure was NICU LOS. Secondary outcome measures were time to first feed, time on respiratory support, incidence of peripheral intravenous (PIV) catheter placement, incidence of intravenous fluid (IVF) administration, incidence of hyponatremia, number of blood draws, and percentage of same-day birth parent-baby discharges. Balancing measures included NICU readmissions, percentage of patients with hypoglycemia, and exposure to breast milk during hospitalization. **Results:** LOS decreased (90 to 51 hours) after study interventions. Time to first feed, time on respiratory support, incidence of hyponatremia, PIV placement, and IVF administration also decreased. Percentage of infants discharged home with their birth parent increased. No changes were noted in any balancing measures. **Conclusion:** By prioritizing clinical guideline development, case audits, and EMR implementations, this quality-improvement initiative resulted in decreased LOS and reduced medical interventions for infants with TTN admitted to a level III and level IV NICU. Copyright © 2026 by the American Academy of Pediatrics. 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