Respiratory Rate

 What is the Respiratory rate?

The respiratory rate (RR) is a part of the vital signs of the human body.

RR is the rate at which breathing occurs in a human per minute and It varies with age.

How to measure breathing rate

The RR is measured by the number of breaths you take per minute. The normal respiration rate for an adult at rest is 12 to 20 breaths per minute.

It is essential to measure a person’s respiratory rate at rest to determine whether it is normal.

Any movement by the person like Exercise or even walking across a room can affect it.

To take an accurate measurement, watch the person’s chest rise and fall. One complete breath comprises one inhalation when the chest rises, followed by one exhalation when the chest falls.

To measure the respiratory rate, count the number of breaths for an entire minute or count for 30 seconds and multiply that number by two.

Brain and respiration

The number of breath we take depend on the coordination of the control center in the brain and the respiratory muscles. An area at the base of the brain controls breathing. The brain sends signals from the brain to the breathing muscles. 

Sometimes, the body needs to adjust the breathing rate. Receptors in the brain detect low oxygen or high carbon dioxide levels and send signals to the body, which can change the breathing rate.

Reasons for abnormal respiratory rate

A respiration rate under 12 or over 25 breaths per minute while resting is considered abnormal with specific terminology. < 12 is bradypnea and more than 25 is tachypnea. 

Having an abnormal respiratory rate can indicate a variety of things. Can various factors affect a person’s breathing rate, including injuries, physical activity, exercise, emotion, mood, and a range of medical conditions?

It is important to take an accurate measurement of the respiratory rate to determine whether or not it is abnormal. 

In some instances, an abnormal breathing rate can indicate an underlying medical issue.

Several conditions induce alterations in respiratory rate or pattern. These modifications occur due to changes in PaO2, PaCO2, or pH levels imposed by the disease process.

Common Causes of a high RR (Tachypnea) include:

• Anxiety: People may breathe faster when they are afraid or anxious. Fast breathing (hyperventilation) is a common symptom of panic attacks. This will usually pass once the anxiety goes away.
• Fever: As body temperature increases with a fever, respiratory rate can also increase. The increase is the body’s way of trying to get rid of the heat.
• Respiratory conditions: Conditions that can increase a person’s respiration rate include:
• Chronic Obstructive Pulmonary Disease (COPD)
• Asthma
• Pneumonia
• Carbon monoxide poisoning
• Pleural effusion
• Pulmonary embolism
• Heart problems: If the heart does not pump properly to get oxygen to the organs, the body may react by breathing faster. Few studies note that respiratory distress is common in those experiencing heart failure.
• Dehydration: Dehydration can increase breathing rate as the body tries to get the energy to the cells.

Other causes of high respiration rates include allergic reactions and diabetic ketoacidosis.

Causes of low RR (Bradypnea)

Bradypnea can occur commonly as a result of a worsening of an underlying respiratory condition or also as a result of airway obstructions and cardiac arrest.

Other causes include:

• A drug overdose: The use of alcohol and other central nervous system depressants, such as narcotics and benzodiazepines, can depress the breathing drive in the brain, leading to low respiration rates.
• Obstructive sleep apnea: Sleep apnea involves a blockage of the airway, often due to the relaxation of the soft tissues in the throat. The blockage causes brief pauses in breathing and may decrease the overall respiratory rate.
• Head injury: Head injuries can affect the area in the brain that plays a role in breathing, which may cause a decrease in the respiration rate.

Medical emergency?

A mild variation in the respiratory rate may not be a cause of concern. But in some cases, a respiratory rate that is too high or too low can be a sign of a medical problem and may require immediate medical attention.

eg., an abnormal RR for a chronic lung disease patient with the signs of infection may require medical attention as that can be a sign of their worsening lung disease.

A child may require urgent medical treatment if:

• cyanosis (bluish discoloration of the skin) whole body or only in extremities or tongue or inside of the lips

• Grunting (gurgling sounds during breathing)
• Bradypnea, apnea, dyspnea (taking few breaths per minute or having severe breathing difficulties) 
• they are exhausted from trying to breathe (fatigue)
• the muscles under their ribs suck in with each breath(retraction)
• Drowsy or disoriented
• their skin turns very pale

Other reasons to seek medical help if their breathing rate increases are as follows:

• Infants between 2 months to 1-year-old: More than 50 breaths per minute.
• Children aged 1–12: More than 40 breaths per minute.
• Children over 12 years old: More than 20 breaths per minute.

Let's Learn together…