
Hypoxic respiratory failure (HRF)
When your newborn can’t breathe
Every year, there are thousands of newborns who, due to illness or being born a little too soon, have trouble breathing.1 Because breathing complications can be serious, your baby may require a long course of treatment in the Neonatal Intensive Care Unit (NICU). For more information about the NICU and caring for your baby, visit the March of Dimes.
Seeing your baby in the NICU with all the monitors and devices may be upsetting, but know that the treatments he or she receives are important and necessary to help your baby breathe. For babies with hypoxic respiratory failure, NICU care can help them survive.
What is HRF?
Hypoxic respiratory failure, also known as HRF, is a condition that occurs when the cells in the body are unable to receive enough oxygen. HRF is a serious condition for newborn infants.2

Why lungs don’t function properly
There are several reasons why a newborn baby’s lungs may not function as they should. Air may not fill the lungs or pass from the lungs into the bloodstream. When a newborn is not getting enough oxygen, HRF can result.3,4 Causes of poor lung function include:
- Respiratory distress syndrome (RDS), occurs most frequently in infants born six or more weeks early whose lungs have not fully developed5
- Meconium aspiration, which occurs when an infant, during or before delivery, inhales amniotic fluid that has been contaminated by a bowel movement1,6
- Congenital diaphragmatic hernia, a defect in the diaphragm that impacts lung formation3
- Pneumonia or sepsis; inflammation of the lungs or an infection3,4
- Pulmonary hypertension, or high blood pressure in the lungs, which occurs when blood vessels in the lungs are constricted.7,8 Pulmonary hypertension can be present with any of the conditions above
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Kinsella JP. Meconium aspiration syndrome: is surfactant lavage the answer? Am J Respir Crit Care Med. 2003;168:413-414.
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Hypoxia [definition]. Dorland's Illustrated Medical Dictionary. 31st ed. Philadelphia, PA: Saunders; 2007:900.
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The Neonatal Inhaled Nitric Oxide Study Group. Inhaled nitric oxide in full-term and nearly full-term infants with hypoxic respiratory failure. New Engl J Med. 1997;336:597-604.
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INOMAX [package insert]. Clinton, NJ: INO Therapeutics LLC; 2007.
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National Heart, Lung and Blood Institute Diseases and Conditions Index. What is respiratory distress syndrome? http://www.nhlbi.nih.gov/health/dci/Diseases/rds/rds_what is.html. Accessed May 11, 2009.
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Meconium aspiration [definition]. Dorland's Illustrated Medical Dictionary. 31st ed. Philadelphia, PA: Saunders; 2007:167.
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Maycock DE. NICU-WEB: persistent pulmonary hypertension of the newborn. http://depts.washington.edu/nicuweb/NICU-WEB/pphn.stm. Accessed May 11, 2009.
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Pulmonary hypertension [definition]. Dorland's Illustrated Medical Dictionary. 31st ed. Philadelphia, PA: Saunders; 2007:889.
