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Respiratory rates of Indian infants under 2 months of age
A Bhandari1, S Singhi, A K Bhalla
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
This study establishes normal respiratory rates (RR) in Indian infants up to 8 weeks old. A RR of 60 breaths/min or higher, observed for one minute, is recommended to define infant tachypnoea.
Area of Science:
- Pediatrics
- Neonatal Care
- Respiratory Physiology
Background:
- Limited data exists on normal respiratory rates (RR) in infants from developing countries like India.
- Establishing accurate RR ranges is crucial for diagnosing respiratory distress in neonates.
Purpose of the Study:
- To determine the normal range of RR in healthy infants up to 8 weeks of age.
- To define tachypnoea using observed RR in this age group.
- To assess the influence of birthweight, gender, and infant state on RR.
Main Methods:
- Studied 100 healthy infants (50 normal, 50 low birthweight) at 1, 2, 4, 6, and 8 weeks.
- Recorded RR by simultaneous observation and auscultation for 60 seconds.
- Compared RR in sleeping vs. awake infants and assessed different counting durations (15, 30, 60 seconds).
Main Results:
- Median RRs ranged from 40-44 breaths/min, with minimal inter-age variability.
- Less than 10% of infants exhibited RR >= 60 breaths/min at any age.
- Observed RR was consistently higher than auscultated RR (p < 0.001).
- Awake infants had significantly higher RRs than sleeping infants.
- RR from 30-second counts closely matched 60-second counts.
Conclusions:
- The study supports using a respiratory rate (RR) of >= 60 breaths/min, observed over 1 minute, as a reliable indicator for defining tachypnoea in infants under 2 months.
- Birthweight and gender did not significantly impact RR.
- Observational RR measurement is effective for assessing infant respiratory status.
Abstract:
There are few data from developing countries, including India, on the normal range of the respiratory rate (RR) recorded by observation. To determine the normal range of RR in infants up to 8 weeks of age and to define tachypnoea, we studied 100 healthy infants, 50 of normal birthweight and 50 of low birthweight) at 1, 2, 4, 6 and 8 weeks of age. The RR was recorded by observation and auscultation simultaneously for 60 seconds on each visit when the baby was either asleep or awake and content. The median RRs ranged between 42 and 43 breaths/min in infants of normal birthweight and 40 and 44 breaths/min. in low birthweight infants. Inter-age variability up to 8 weeks of age was very slight and statistically insignificant. Only 2-10% of the infants at any given age had a RR > or = 60/min. At all ages, RR by observation was higher than that by auscultation (p < 0.001). Neither birthweight nor gender significantly influenced the RR. When awake, infants had significantly higher RRs than when asleep. The RR extrapolated from a 15-second breath count was significantly lower (p < 0.05-0.01), whereas results from 30-second counts were similar to 60-second counts. Our data endorse the use of a RR > or = 60 breaths/min. counted for 1 minute as a cut-off to define tachypnoea in infants < 2 months of age.