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Normal Percentiles for Respiratory Rate in Children-Reference Ranges Determined from an Optical Sensor
Anthony Herbert1,2, John Pearn1,2, Stephen Wilson3
1Children's Health Queensland Hospital and Health Service, 4101 Brisbane, Australia.
Insights
New respiratory rate (RR) centile charts for children aged 0-13 years show higher RRs when awake. These charts help identify abnormal breathing rates in children, especially differentiating between awake and sleeping states.
Area of Science:
- Pediatrics
- Respiratory Physiology
- Biomedical Engineering
Background:
- Elevated respiratory rates (RRs) are indicators of various pediatric conditions like pneumonia and asthma.
- Current methods for deriving RR centiles in healthy children are inconsistent and may influence the measured rate.
- There's a need for standardized, objective methods to establish normal RR ranges.
Purpose of the Study:
- To develop accurate centile charts for respiratory rates in healthy children from birth to 13 years.
- To differentiate and present RR data for both awake and sleeping states.
- To provide a reliable tool for identifying abnormal respiratory rates in pediatric populations.
Main Methods:
- Utilized an optical respiratory sensor for non-invasive, objective RR measurement in children.
- Collected data from a cross-sectional sample of 560 awake and 103 sleeping healthy children in Brisbane, Australia.
- Analyzed data from 320 awake and 94 sleeping children to generate centile charts.
Main Results:
- Respiratory rates are significantly higher in awake children compared to sleeping children, particularly in younger age groups.
- Median awake RR at birth was 59.3 breaths/min, decreasing to 25.4 at 3 years.
- Median sleeping RR at birth was 41.4 breaths/min, decreasing to 22.0 at 3 years.
Conclusions:
- The developed centile charts provide a crucial reference for assessing pediatric respiratory rates.
- These charts will aid in the early detection of abnormal breathing patterns in children.
- Highlighting the impact of sleep state on RR, especially in children aged 0-3 years, is vital for accurate clinical assessment.
Abstract:
(1) Background: Increased respiratory rates (RRs) are described in several medical conditions, including pneumonia, bronchiolitis and asthma. There is variable methodology on how centiles for RR are derived in healthy children. Available age percentiles for RR have been generated using methods that have the potential themselves to alter the rate. (2) Methods: An optical respiratory sensor was used to measure RR. This technique enabled recording in awake children without the artefact of the observer's presence on the subject's RR. A cross-sectional sample of healthy children was obtained from maternity wards, childcare centres and schools in Brisbane, Queensland, Australia. (3) Results: RRs were observed in 560 awake and 103 sleeping children of which data from 320 awake and 94 sleeping children were used to develop centile charts for children from birth to 13 years of age. RR is higher when children are awake compared to asleep. There were significant differences between awake and sleeping RR in young children. The awake median RR was 59.3 at birth and 25.4 at 3 years of age. In comparison, the median sleeping RR was 41.4 at birth and 22.0 at 3 years. (4) Conclusions: The centile charts will assist in determining abnormal RRs in children and will contribute to further systematic reviews related to this important vital sign. This is particularly in relation to the data on children aged from 0 to 3 years, where data are presented on both the awake and sleeping state. Many studies in the literature fail to acknowledge the impact of sleep state in young children on RR.
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