The respiratory rate (RR), also known as the respiration rate, ventilation rate, ventilatory rate, ventilation frequency (Vf), respiration frequency (Rf), pulmonary ventilation rate, or breathing frequency, is the rate (frequency) of ventilation, that is, the number of breaths (inhalation-exhalation cycles) taken within a set amount of time (typically 60 seconds). A normal respiratory rate is termed eupnea, an increased respiratory rate is termed tachypnea and a lower-than-normal respiratory rate is termed bradypnea.
Breathing (which in organisms with lungs is called ventilation and includes inhalation and exhalation) is a part of respiration. Thus, in precise usage, the words breathing and ventilation are hyponyms, not synonyms, of respiration; but this prescription is not consistently followed, even by most health care providers, because the term respiratory rate (RR) is a well-established term in health care, even though it would need to be consistently replaced with ventilation rate if the precise usage were to be followed.
Contents
- 1 Measurement
- 2 Normal range
- 3 Minute volume
- 4 Diagnostic value
- 5 Abnormal respiratory rates
- 6 See also
- 7 References
Measurement
Human respiration rate is measured when a person is at rest and involves counting the number of breaths for one minute by counting how many times the chest rises. An optical breath rate sensor can be used for monitoring patients during a magnetic resonance imaging scan.[1] Respiration rates may increase with fever, illness, or other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing.
Inaccuracies in respiratory measurement have been reported in the literature. One study compared respiratory rate counted using a 90-second count period, to a full minute, and found significant differences in the rates.[citation needed] Another study found that rapid respiratory rates in babies, counted using a stethoscope, were 60–80% higher than those counted from beside the cot without the aid of the stethoscope.[citation needed] Similar results are seen with animals when they are being handled and not being handled—the invasiveness of touch apparently is enough to make significant changes in breathing.
Various other methods to measure respiratory rate are commonly used, including impedance pneumography,[2] and capnography which are commonly implemented in patient monitoring.
Normal range
The typical respiratory rate for a healthy adult at rest is 12–20 breaths per minute.[3]
Average resting respiratory rates by age are:[4][5]
- birth to 6 weeks: 30–60 breaths per minute
- 6 months: 25–40 breaths per minute
- 3 years: 20–30 breaths per minute
- 6 years: 18–25 breaths per minute
- 10 years: 17–23 breaths per minute
- Adults: 12-18-breaths per minute[3]
- Elderly ≥ 65 years old: 12-28 breaths per minute.[6]
- Elderly ≥ 80 years old: 10-30 breaths per minute.[6]
Minute volume
Respiratory minute volume is the volume of air which is inhaled (inhaled minute volume) or exhaled (exhaled minute volume) from the lungs in one minute.
Diagnostic value
The value of respiratory rate as an indicator of potential respiratory dysfunction has been investigated but findings suggest it is of limited value.
One study found that only 33% of people presenting to an emergency department with an oxygen saturation below 90% had an increased respiratory rate.[citation needed] An evaluation of respiratory rate for the differentiation of the severity of illness in babies under 6 months found it not to be very useful. Approximately half of the babies had a respiratory rate above 50 breaths per minute, thereby questioning the value of having a "cut-off" at 50 breaths per minute as the indicator of serious respiratory illness.
It has also been reported that factors such as crying, sleeping, agitation and age have a significant influence on the respiratory rate.[citation needed] As a result of these and similar studies the value of respiratory rate as an indicator of serious illness is limited.
Abnormal respiratory rates
- Apnea
- Dyspnea
- Hyperpnea
- Tachypnea
- Hypopnea
- Bradypnea
- Orthopnea
- Platypnea
- Biot's respiration
- Cheyne-Stokes respiration
- Kussmaul breathing
See also
- Kölliker-Fuse nucleus - nucleus in the brain stem that regulates breathing rate
References
- ^ [1]
- ^ Grenvik, A., Ballou, S., McGinley, E., Millen, J., Cooley, W.L., Safar P. (1972) Impedance Pneumography: Comparison between Chest Impedance Changes and Respiratory Volumes in II Healthy Volunteers. Chest. October 1972;62(4):439-443 [2]
- ^ a b Ganong's Review of Medical Physiology (24 ed.). p. 619. ISBN 0071780033.
- ^ Scott L. DeBoer (4 November 2004). Emergency Newborn Care. Trafford Publishing. p. 30. ISBN 978-1-4120-3089-2.
- ^ Wilburta Q. Lindh; Marilyn Pooler; Carol Tamparo; Barbara M. Dahl (9 March 2009). Delmar's Comprehensive Medical Assisting: Administrative and Clinical Competencies. Cengage Learning. p. 573. ISBN 978-1-4354-1914-8.
- ^ a b Rodríguez-Molinero A. et al., Normal respiratory rate and peripheral blood oxygen saturation in the elderly population. J Am Geriatr Soc. 2013 Dec;61(12):2238-40.
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Respiratory physiology
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| Lung volumes |
- VC
- FRC
- Vt
- dead space
- CC
- PEF
- calculations
- respiratory minute volume
- FEV1/FVC ratio
- methods of lung testing
- spirometry
- body plethysmography
- peak flow meter
- nitrogen washout
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| Airways/ventilation (V) |
- positive pressure ventilation
- breath (inhalation
- exhalation)
- respiratory rate
- respirometer
- pulmonary surfactant
- compliance
- elastic recoil
- hysteresivity
- airway resistance
- bronchial hyperresponsiveness
- bronchoconstriction/Bronchodilatation
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| Blood/perfusion (Q) |
- pulmonary circulation
- hypoxic pulmonary vasoconstriction
- pulmonary shunt
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Interactions/
ventilation/perfusion ratio (V/Q) |
- ventilation/perfusion scan
- zones of the lung
- gas exchange
- pulmonary gas pressures
- alveolar gas equation
- alveolar–arterial gradient
- hemoglobin
- oxygen–haemoglobin dissociation curve (Oxygen saturation
- 2,3-BPG
- Bohr effect
- Haldane effect)
- carbonic anhydrase (chloride shift)
- oxyhemoglobin
- respiratory quotient
- arterial blood gas
- diffusion capacity (DLCO)
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| Control of respiration |
- pons
- pneumotaxic center
- apneustic center
- medulla
- dorsal respiratory group
- ventral respiratory group
- chemoreceptors
- pulmonary stretch receptors
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| Insufficiency |
- high altitude
- oxygen toxicity
- hypoxia
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Index of the respiratory system
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Chest trauma
- Infection
- common cold
- pneumonia
- tuberculosis
- Other
- Symptoms and signs
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| Treatment |
- Procedures
- Drugs
- nasal
- throat
- obstructive airway diseases
- cough and cold
- histaminergics
- pulmonary arterial hypertension
- other
- Surgery
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Medical examination and history taking
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| Medical history |
- Chief complaint
- History of the present illness
- Systems review
- Allergies
- Past medical history
- Family history
- Social history
- Psychiatric history
- Progress notes
- Mnemonics
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| Physical examination |
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General/IPPA
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- Inspection
- Auscultation
- Palpation
- Percussion
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Vital signs
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- Temperature
- Heart rate
- Blood pressure
- Respiratory rate
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HEENT
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Oral mucosa · TM · Eyes (Ophthalmoscopy, Swinging-flashlight test) · Hearing (Weber, Rinne)
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Respiratory
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- Respiratory signs and symptoms
- Respiratory sounds
- Cyanosis
- Clubbing
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Cardiovascular
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- Precordial examination
- Peripheral vascular examination
- Cardiovascular signs and symptoms
- Other
- Jugular venous pressure
- Abdominojugular test
- Carotid bruit
- Ankle brachial pressure index
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Abdominal
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Digestive
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Liver span · Rectal · Murphy's sign · Bowel sounds
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Urinary
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Murphy's punch sign
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Extremities/Joint
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Back (Straight leg raise) · Knee (McMurray test) · Hip · Wrist (Tinel sign, Phalen maneuver) · Shoulder (Adson's sign) · GALS screen
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Neurological
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- Mental state
- Mini–mental state examination
- Cranial nerve examination
- Upper limb neurological examination
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Neonatal
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- Apgar score
- Ballard Maturational Assessment
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Gynecological
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- Well-woman examination
- Vaginal examination
- Breast examination
- Cervical motion tenderness
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| L/I |
Labs (Electrolytes, ABG, LFT) · Medical imaging (EKG, CXR, CT, MRI)
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| A/P |
Medical diagnosis · Differential diagnosis
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