Respiratory flutter syndrome: An underrecognized cause of respiratory failure in neonates

Eliot S. Katz, Estelle Gauda, Thomas Crawford, Folasade Ogunlesi, Maureen A. Lefton-Greif, Sharon McGrath-Morrow, Carole L. Marcus

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


We report the clinical and respiratory data of three neonates with flutter of the diaphragm and intercostal muscles, presenting soon after birth with respiratory failure. The breathing pattern was dirhythmic with superimposed frequencies, one regular and slow (60/min) representing the underlying respiratory rate, the other fast (> 300/min) and limited to inspiration. Nasal continuous positive airway pressure immediately normalized the breathing pattern in one infant, and improved ventilation in the two others. Pharmacologic therapy with chlorpromazine terminated the respiratory flutter and permitted weaning of ventilatory support within a few hours. Coexistent dysphagia suggested a disorder of brainstem function, although the children were otherwise developmentally normal at 8, 10, and 26 mo old. Laryngomalacia and gastroesophageal reflux were also present. We propose that the occurrence of respiratory flutter, dysphagia, laryngomalacia, and gastroesophageal reflux in a neonate constitutes a distinct clinical entity, termed the "respiratory flutter syndrome." The diagnosis of three infants with this presentation during an 18-mo period suggests that this may be a more frequent cause of respiratory failure in newborns than previously recognized.

Original languageEnglish (US)
Pages (from-to)1161-1164
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Issue number7
StatePublished - Oct 1 2001


  • Chlorpromazine
  • Continuous positive airway pressure
  • Diaphragmatic flutter
  • Dysphagia
  • Hiccups

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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