Related Experiment Video
Updated: Jan 30, 2026
Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
Temperature-Adjusted Respiratory Rate for the Prediction of Childhood Pneumonia
Richard G Bachur1, Kenneth A Michelson1, Mark I Neuman1
1Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Insights
Adjusting respiratory rate (RR) for fever in children improves pneumonia prediction. This temperature-adjusted RR enhances diagnostic accuracy, even with variations in individual responses.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Physiology
- Diagnostic Accuracy
Background:
- Fever and pneumonia are common in children and can cause tachypnea (rapid breathing).
- The relationship between body temperature and respiratory rate (RR) in children is not fully understood in the context of pneumonia diagnosis.
Purpose of the Study:
- To investigate the relationship between body temperature and RR in young children.
- To determine if temperature-adjusted RR improves the prediction of pneumonia.
Main Methods:
- Retrospective cross-sectional analysis of 91,429 children under 5 years old.
- Regression analysis to examine the link between triage RR and temperature.
- Assessed predictive value of temperature-adjusted RR versus age-adjusted RR and World Health Organization (WHO) criteria.
Main Results:
- Mean RR increased by 2.6 breaths/minute per 1°C rise in temperature, with significant interpatient variability.
- Temperature- and age-adjusted RR showed superior pneumonia prediction (AUC=0.76) compared to age-adjusted RR alone (AUC=0.73).
- Temperature adjustment improved diagnostic discrimination using WHO criteria (AUC increased from 0.58 to 0.72).
Conclusions:
- Temperature has a modest effect on RR (2.6 breaths/min per 1°C).
- Despite variability, temperature adjustment significantly enhances the diagnostic value of RR for predicting pneumonia in children.
Objectives:
As both fever and pneumonia can be associated with tachypnea, we investigated the relationship between body temperature and respiratory rate (RR) in young children and whether temperature-adjusted RR enhances the prediction of pneumonia.
Methods:
In this retrospective cross-sectional analysis of 91,429 children < 5 years of age presenting to an urban pediatric emergency department, the relationship between triage RR and temperature was analyzed using regression analysis. We assessed the predictive value of temperature-adjusted RR for the diagnosis of pneumonia; diagnostic performance was evaluated for continuous RR as well as World Health Organization (WHO) age-based RR thresholds.
Results:
The mean RR increased 2.6 breaths/minute for each 1°C increase in temperature. Interpatient variability was comparatively large; at any temperature, the interquartile range (75th percentile minus 25th percentile) varied from 4 to 16 breaths/minute. For predicting pneumonia, temperature- and age-adjusted RR was superior to age-adjusted RR: area under the curve (AUC) = 0.76 (95% confidence interval [CI], 0.75-0.78) versus AUC = 0.73 (95% CI, 0.72-0.75), respectively. Using WHO RR criteria, temperature-adjusted RR improved diagnostic discrimination, as the AUC increased from 0.58 (95% CI, 0.57-0.59) to 0.72 (95% CI, 0.70-0.73).
Conclusions:
The effects of temperature on respiratory rate are modest, with a mean increase of 2.6 breaths/minute for each 1°C rise in temperature. Despite considerable interpatient variability in respiratory rates by temperature, temperature adjustment improves the diagnostic value of respiratory rate for pneumonia.
More Related Videos
Related Concept Videos
02:55Temperature Dependence on Reaction Rate
Atoms, molecules, or ions must collide before they can react with each other. Atoms must be close together to form chemical bonds. This premise is the basis for a theory that explains many observations regarding chemical kinetics, including factors affecting reaction rates.
The collision theory is based on the postulates that (i) the reaction rate is proportional to the rate of reactant collisions, (ii) the reacting species collide in an orientation allowing contact between...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
02:28Effect of Temperature Change on Reaction Rate
01:25The Anchoring-and-Adjustment Heuristic
01:12Adjusting a Traverse
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...