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Lancet (London, England) Mar 2011Although heart rate and respiratory rate in children are measured routinely in acute settings, current reference ranges are not based on evidence. We aimed to derive new... (Review)
Review
BACKGROUND
Although heart rate and respiratory rate in children are measured routinely in acute settings, current reference ranges are not based on evidence. We aimed to derive new centile charts for these vital signs and to compare these centiles with existing international ranges.
METHODS
We searched Medline, Embase, CINAHL, and reference lists for studies that reported heart rate or respiratory rate of healthy children between birth and 18 years of age. We used non-parametric kernel regression to create centile charts for heart rate and respiratory rate in relation to age. We compared existing reference ranges with those derived from our centile charts.
FINDINGS
We identified 69 studies with heart rate data for 143,346 children and respiratory rate data for 3881 children. Our centile charts show decline in respiratory rate from birth to early adolescence, with the steepest fall apparent in infants under 2 years of age; decreasing from a median of 44 breaths per min at birth to 26 breaths per min at 2 years. Heart rate shows a small peak at age 1 month. Median heart rate increases from 127 beats per min at birth to a maximum of 145 beats per min at about 1 month, before decreasing to 113 beats per min by 2 years of age. Comparison of our centile charts with existing published reference ranges for heart rate and respiratory rate show striking disagreement, with limits from published ranges frequently exceeding the 99th and 1st centiles, or crossing the median.
INTERPRETATION
Our evidence-based centile charts for children from birth to 18 years should help clinicians to update clinical and resuscitation guidelines.
FUNDING
National Institute for Health Research, Engineering and Physical Sciences Research Council.
Topics: Adolescent; Advanced Cardiac Life Support; Child; Child, Preschool; Heart Rate; Humans; Infant; Infant, Newborn; Practice Guidelines as Topic; Reference Values; Respiratory Rate
PubMed: 21411136
DOI: 10.1016/S0140-6736(10)62226-X -
Sensors (Basel, Switzerland) Nov 2020Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration)... (Review)
Review
Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.
Topics: Delivery of Health Care; Exercise; Humans; Monitoring, Physiologic; Respiratory Rate; Sports Medicine; Vital Signs
PubMed: 33182463
DOI: 10.3390/s20216396 -
Acta Paediatrica (Oslo, Norway : 1992) Mar 2023
Topics: Humans; Child; Infant; Respiratory Rate; Respiratory Tract Infections
PubMed: 36605003
DOI: 10.1111/apa.16645 -
Sensors (Basel, Switzerland) Feb 2019There is an ever-growing demand for measuring respiratory variables during a variety of applications, including monitoring in clinical and occupational settings, and... (Review)
Review
There is an ever-growing demand for measuring respiratory variables during a variety of applications, including monitoring in clinical and occupational settings, and during sporting activities and exercise. Special attention is devoted to the monitoring of respiratory rate because it is a vital sign, which responds to a variety of stressors. There are different methods for measuring respiratory rate, which can be classed as contact-based or contactless. The present paper provides an overview of the currently available contact-based methods for measuring respiratory rate. For these methods, the sensing element (or part of the instrument containing it) is attached to the subject's body. Methods based upon the recording of respiratory airflow, sounds, air temperature, air humidity, air components, chest wall movements, and modulation of the cardiac activity are presented. Working principles, metrological characteristics, and applications in the respiratory monitoring field are presented to explore potential development and applicability for each method.
Topics: Exercise; Humans; Monitoring, Physiologic; Respiration; Respiratory Rate; Thoracic Wall
PubMed: 30795595
DOI: 10.3390/s19040908 -
Anesthesiology Apr 2023
Topics: Humans; Lung Injury; Respiratory Rate
PubMed: 36880786
DOI: 10.1097/ALN.0000000000004502 -
Journal of Mathematical Biology Oct 2022All schoolchildren know how often they breathe, but even experts don't know exactly why. The aim of this publication is to develop a model of the resting spontaneous...
All schoolchildren know how often they breathe, but even experts don't know exactly why. The aim of this publication is to develop a model of the resting spontaneous breathing rate using physiological, physical and mathematical methods with the aid of the principle that evolution pushes physiology in a direction that is as economical as possible. The respiratory rate then follows from an equation with the parameters [Formula: see text]-production rate of the organism, resistance, static compliance and dead space of the lungs, the inspiration duration: expiration duration - ratio and the end-expiratory [Formula: see text] fraction. The derivation requires exclusively secondary school mathematics. Using the example of an adult human or a newborn child, data from the literature then result in normal values for their breathing rate at rest. The reason for the higher respiratory rate of a newborn human compared to an adult is the relatively high [Formula: see text]-production rate together with the comparatively low compliance of the lungs. A side result is the fact that the common alveolar pressure throughout the lungs and the common time constant is a consequence of the economical principle as well. Since the above parameters are not human-specific, there is no reason to assume that the above equation could not also be applicable to many animals breathing through lungs within a thorax, especially mammals. Not only physiology and biology, but also medicine, could benefit: Applicability is being discussed in pulmonary function diagnostics, including pathophysiology. However, the present publication only claims to be a theoretical concept of the spontaneous quiet breathing rate. In the absence of comparable animal data, this publication is intended to encourage further scientific tests.
Topics: Humans; Adult; Animals; Infant, Newborn; Child; Respiratory Rate; Lung; Mammals
PubMed: 36282355
DOI: 10.1007/s00285-022-01790-8 -
British Journal of Nursing (Mark Allen... Jan 2020
Topics: Adult; Humans; Monitoring, Physiologic; Practice Guidelines as Topic; Respiratory Rate
PubMed: 31917943
DOI: 10.12968/bjon.2020.29.1.12 -
Deutsche Medizinische Wochenschrift... Jan 2017
Review
Topics: Diagnosis, Differential; Humans; Respiration Disorders; Respiratory Rate; Vital Signs
PubMed: 28114720
DOI: 10.1055/s-0042-120485 -
American Journal of Respiratory and... Jan 2019Respiratory rate is one of the key variables that is set and monitored during mechanical ventilation. As part of increasing efforts to optimize mechanical ventilation,... (Review)
Review
Respiratory rate is one of the key variables that is set and monitored during mechanical ventilation. As part of increasing efforts to optimize mechanical ventilation, it is prudent to expand understanding of the potential harmful effects of not only volume and pressures but also respiratory rate. The mechanisms by which respiratory rate may become injurious during mechanical ventilation can be distinguished in two broad categories. In the first, well-recognized category, concerning both controlled and assisted ventilation, the respiratory rate per se may promote ventilator-induced lung injury, dynamic hyperinflation, ineffective efforts, and respiratory alkalosis. It may also be misinterpreted as distress delaying the weaning process. In the second category, which concerns only assisted ventilation, the respiratory rate may induce injury in a less apparent way by remaining relatively quiescent while being challenged by chemical feedback. By responding minimally to chemical feedback, respiratory rate leaves the control of e almost exclusively to inspiratory effort. In such cases, when assist is high, weak inspiratory efforts promote ineffective triggering, periodic breathing, and diaphragmatic atrophy. Conversely, when assist is low, diaphragmatic efforts are intense and increase the risk for respiratory distress, asynchronies, ventilator-induced lung injury, diaphragmatic injury, and cardiovascular complications. This review thoroughly presents the multiple mechanisms by which respiratory rate may induce injury during mechanical ventilation, drawing the attention of critical care physicians to the potential injurious effects of respiratory rate insensitivity to chemical feedback during assisted ventilation.
Topics: Humans; Lung; Respiration, Artificial; Respiratory Rate; Ventilator Weaning; Ventilator-Induced Lung Injury
PubMed: 30199652
DOI: 10.1164/rccm.201804-0726CI -
Neuroscience and Biobehavioral Reviews Apr 2022Clinical research on the beneficial effects induced by slow-paced breathing has been increasingly extended in the past twenty years. Improvements in cardiovascular... (Review)
Review
Clinical research on the beneficial effects induced by slow-paced breathing has been increasingly extended in the past twenty years. Improvements in cardiovascular functioning, executive functions, or stress management appear to be among the most prominent observations in these studies. However, the mechanisms underlying these effects are multiple and complex. This review will focus on the importance of reducing breathing rate at the resonant frequency (~ 0.1 Hz), which increases cardiac oscillations, thus reflecting improved vagally-mediated heart rate variability and baroreflex sensitivity. These effects are achieved through temporal coherence of respiratory, blood pressure, and cardiac phases, which are the origin of multiple peripheral benefits. In return, vagal afferents, which send inputs to interoceptive areas, are stimulated for longer and more intensely than when breathing spontaneously. In limbic areas, which may also be stimulated through larger cerebral blood flow oscillations and increases in oxygen delivery, interoceptive activation produces a cascade of neural activations that may be at the origin of the central benefits of deep and slow-paced breathing.
Topics: Baroreflex; Blood Pressure; Heart Rate; Humans; Respiration; Respiratory Rate; Vagus Nerve
PubMed: 35167847
DOI: 10.1016/j.neubiorev.2022.104576