Tachypnoea in a well baby: what to do next?

Balfour‐Lynn, Ian M.; Rigby, Michael L.

doi:10.1136/archdischild-2014-306692

Cited by 6 publications

(3 citation statements)

References 38 publications

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“…8 Occasionally murmurs may be heard away from the heart, as for example over the head from a large arteriovenous fistula involving the vein of Galen. 9 Tachypnoea Tachypneoa on day 1 or 2 is generally non-cardiac in origin 10 unless caused by significant aortic runoffs beyond the heart and lungs, 9 or resulting from a failing myocardium from a cardiomyopathy 11 or myocarditis. 12 Tachypnoea from substantial left to right shunts, as for example a large VSD or patent duct, takes a week or more to develop and is dependent on how rapidly the pulmonary vascular resistance (PVR) falls.…”

Section: Murmursmentioning

confidence: 99%

Early detection of significant congenital heart disease: The contribution of fetal cardiac ultrasound and newborn pulse oximetry screening

Menahem

Sehgal

Meagher

2021

J Paediatrics Child Health

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Fetal cardiac and newborn pulse oximetry screening has greatly facilitated the detection of cardiac abnormalities, which may be serious with potentially dire neonatal consequences. The prenatal diagnosis of a serious cardiac abnormality allows the attending obstetrician to organise the much safer in‐utero transfer of the fetus for delivery at a tertiary centre, particularly if there is evidence of a duct‐dependent lesion that may require the infusion of Prostaglandin E1 to maintain duct patency pending surgical intervention. Newborn pulse oximetry alerts the paediatrician that the baby may have a significant cardiac abnormality, which warrants further elucidation prior to discharge, rather than for the baby to represent unwell a few days later. Despite these advances, serious cardiac abnormalities may be missed on screening. Their detection then falls back onto the clinical acumen of the attending paediatrician/family physician to review the history, carefully elicit and evaluate the clinical signs further aided by whatever investigations that may be available at the birthing hospital, frequently less resourced than the tertiary centres. At the outset, a brief synopsis is provided of the clinical findings that may point to a cardiac abnormality. That is followed by a critical review of the accuracy of prenatal and newborn pulse oximetry screening with emphasis on the lesions that may be missed. Suggestions are made as to how to improve the diagnostic accuracy.

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Section: Murmursmentioning

confidence: 99%

Early detection of significant congenital heart disease: The contribution of fetal cardiac ultrasound and newborn pulse oximetry screening

Menahem

Sehgal

Meagher

2021

J Paediatrics Child Health

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“…To compensate for impaired gas exchange, infants and young children increase minute volume predominantly by increasing respiratory rate to maintain blood oxygenation. Tachypnoea in infants is an early and consistent marker of a number of acute conditions including infection1 and can also be the presenting sign in a wide variety of congenital respiratory, cardiac and neurological disorders 2. Thus, respiratory rate is a key measurement for sick and vulnerable infants and children,1 2 and monitoring it could help in early identification and treatment of disease.…”

Section: Introductionmentioning

confidence: 99%

“…Tachypnoea in infants is an early and consistent marker of a number of acute conditions including infection1 and can also be the presenting sign in a wide variety of congenital respiratory, cardiac and neurological disorders 2. Thus, respiratory rate is a key measurement for sick and vulnerable infants and children,1 2 and monitoring it could help in early identification and treatment of disease. However, at present, monitoring respiration requires the use of sensors such as effort bands or nasal thermistor, which are problematic for regular clinical use.…”

Section: Introductionmentioning

confidence: 99%

Infant home respiratory monitoring using pulse oximetry

2016

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Respiratory rate (RR) is a valuable early marker of illness in vulnerable infants, but current monitoring methods are unsuitable for sustained home use. We have demonstrated accurate measurement of RR from brief recordings of pulse oximeter plethysmogram (pleth) trace in term neonates in hospital. This study assessed the feasibility of this method in preterm infants during overnight recordings in the home. We collected simultaneous overnight SpO 2 , pleth and RIP on 24 preterm infants in the home. RR from pleth analysis was compared to RR from RIP bands; pleth quality was assessed by presence of visible artefact. Median (range) RR from RIP and pleth were not significantly different at 42 (25-65) and 42 (25-64) breaths/minute. Median (range) % of epochs rejected due to artefact was 20 (8-75) for pleth and 10 (3-53) for RIP. Our results suggest that home respiratory rate monitoring by pulse oximeter pleth signal is accurate and feasible.

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