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.

Highlights

  • Counting and recording respiratory rate (RR) comprises one of the fundamentals of prehospital, medical and nursing assessments

  • (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

  • A total of 540 awake and 103 sleeping participants had their RR measured, of whom 197 awake children were excluded as they had a history of respiratory illness or cardiac disease, leaving data on 323 awake and 94 sleeping children, who were included in the calculations of reference ranges

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Summary

Introduction

Counting and recording respiratory rate (RR) comprises one of the fundamentals of prehospital, medical and nursing assessments. RR is increased in both respiratory (e.g., pneumonia, bronchiolitis, and asthma) and nonrespiratory conditions (e.g., sepsis and ingestions) [1,2,3,4,5]. RR is important in monitoring children receiving opioid analgesics and an important early warning sign of the clinical deterioration of patients including children [6,7,8]. The medical literature and textbooks pay homage to RR as an important clinical sign. Studies have found that RR is either not recorded by nursing staff or is poorly performed [9,10,11,12].

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