What is the most likely cause of tachypnea in a 2-hour-old infant born at 32 weeks gestational age?

In a 2-hour-old infant born at 32 weeks gestational age, tachypnea is most commonly attributed to respiratory distress syndrome (RDS). This condition is prevalent in premature infants because their lungs may not be fully developed, particularly in the production of surfactant. Surfactant is a crucial substance that reduces surface tension in the alveoli, preventing their collapse during exhalation. Inadequate surfactant leads to atelectasis (lung collapse) and impairs gas exchange, resulting in respiratory distress characterized by rapid breathing, or tachypnea.

While infection, pneumothorax, and congenital heart disease can also cause tachypnea, they are less likely to be the primary cause in a very young preterm infant. Infection is a concern but typically presents with other symptoms and is less immediate than RDS in this context. Pneumothorax, while it can occur in neonates, is a more acute condition and often presents with acute respiratory distress or decreased breath sounds, rather than isolated tachypnea. Congenital heart disease may indeed cause respiratory distress but typically has additional clinical signs, such as cyanosis or abnormal heart sounds, that would help differentiate it from RDS.

In summary, RDS