Signs of Respiratory Distress in Children

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Introduction[edit | edit source]

One of the most common reasons an infant is admitted to the neonatal intensive care unit is due to Respiratory distress (1). Respiratory distress can be recognised as one or more signs of increased work of breathing which will be discussed below.

Signs and symptoms and their causes[edit | edit source]

  • Weak cry
    • sign of fatigue and shows the child is prioritising energy expenditure for work of breathing.
  • Grunting
    • Increase positive end expiatory pressure (PEEP) by closing of the glottis (therefore increasing Functional Residual Capacity (FRC).
  • Tachypnoea
    • Unable to increase Tidal volume and therefore increase Respiratory rate.
  • Cricoid Tug/Tracheal tug
    • Increase pull of diaphragm is transmitted as a downwards tug on the trachea during inspiration.
  • Sternal recession
    • Due to high negative pressures on inspiration.
  • Sub-costal recession
    • Due to high negative pressures on inspiration.
  • Intercostal recession
    • Due to high negative pressures on inspiration.
  • Nasal flaring
    • To help increase the diameter of the airway.
  • Head bopping
    • Due to high use of sternocleidomastoid and scalene muscles.
  • Clammy
    • Due to high energy expenditure to breathe therefore sweating to regulate temperature.
  • Pallor
    • Not oxygenating effectively.
  • Cyanosis
    • Dependent on haemoglobin and peripheral circulation-indicates poor oxygen saturation levels.
  • Stridor
    • Partial obstruction of upper trachea.
  • Wheeze
    • Narrowing or obstruction of the small airways by secretions or inflammation.
  • Lethargy
    • Being breathless and working hard causes discomfort and agitation. Also reserved energy fro work of breathing.
  • Tachycardia
    • to assist in oxygen transport.
  • Hypoxemia
    • reduced ability to oxygenate.
  • Hypercarbia
    • reduced ability to expire carbon dioxide.

Resources[edit | edit source]

References[edit | edit source]

references /> " Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr Respir Rev. 2013 Mar; 14(1):29-36; quiz 36-7." /> Wheeler', Derek S., Wong, Hector R., Shanley, Thomas P. (Eds.).The Respiratory Tract in Pediatric Critical Illness and Injury. =

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