Tachypnea is a condition that refers to rapid breathing. The normal breathing rate for an average adult is 12 to 20 breaths per minute. In children, the number of breaths per minute can be a higher resting rate than seen in adults.
Tachypnea does not necessarily have a pathological cause. For example, exercise can cause tachypnea. Some pathological causes of tachypnea are sepsis, diabetic ketoacidosis, respiratory issues such as pneumonia, carbon monoxide poisoning, pulmonary embolism, pleural effusion, asthma or COPD. Other medical issues such as allergic reactions, anxiety states, and foreign body aspiration can cause tachypnea as well.
Tachypnea in the newborn is a problem with the respiratory system that can be seen shortly after delivery. It can result from impaired clearance of fetal lung fluid which leads to respiratory distress. Transient tachypnea of the newborn has a higher prevalence in preterm infants. It occurs in approximately 1 in 100 preterm infants whereas, in term infants, it presents in about 4 to 6 per 1000 infants.
Tachypnea in adults is breathing more than 20 breaths per minute. Twelve to twenty breaths per minute is a normal range.
Tachypnea is a term used to define rapid and shallow breathing, which should not be confused with hyperventilation, which is when a patient's breathing is rapid but deep. Both are similar in that both result from a buildup of carbon dioxide in the lungs leading to an increase of carbon dioxide in the blood.
This buildup of carbon dioxide in the blood makes the blood more acidic than usual, which alerts the brain and in response, the brain signals the respiratory drive to increase in pace in an attempt to correct the imbalance. In doing so, the blood pH can return to within the normal range in acidity.
Patients may present with complaints of feeling short of breath. They also may say that they do not feel as if they can get in enough air. On physical exam, patients may have blue-tinged fingers or lips and/or use of accessory muscles or chest muscles to breathe. On the other hand, patients can present without any obvious symptoms.
In newborns, tachypnea can be due to fluid retention in the lungs within the first 24 hours of birth. Infants can present with a blue color in the perioral area, grunting or signs of difficulty breathing, retraction of the chest while breathing, bobbing of the head and/or flared nostrils.
The evaluation and cause of tachypnea are dependent on the patient's general disposition. Providers can evaluate based on oximetry, arterial blood gases, chest X-ray, chest CT, pulmonary function tests, glucose, electrolytes, hemoglobin, EKG, VQ scan, brain MRI and/or a toxicology screen.
Arterial blood gases give an estimate of oxygen and carbon dioxide content which can assist in determining the pH as well as metabolic abnormalities. If the pH indicates acidosis, some potential causes are diabetic ketoacidosis, lactic acidosis or hepatic encephalopathy. A blood sugar, if taken, can indicate or rule out diabetic ketoacidosis as well.
A chest X-ray can depict any pulmonary causes of tachypnea, such as a pneumothorax, cystic fibrosis or pneumonia. A chest CT, which shows greater detail, can be used to indicate any other lung pathologies or potential malignancies. Apart from imaging, pulmonary function tests can help determine causes from obstructive lung diseases such as COPD or asthma. VQ scans can be helpful if signs and symptoms point to a potential pulmonary embolus. If tachypnea is due to cardiac abnormalities, an EKG will show evidence of a heart attack or abnormal heart rhythms.
A complete blood count and complete metabolic panel can indicate any evidence for anemia or infections, which can potentially cause tachypnea. A toxicology screen can determine if there are any drugs, both prescription or non-prescribed, that may be causing tachypnea.
Tachypnea should be treated depending on the underlying cause.
If infants present due to transient tachypnea of the newborn, they can have treatment with extra oxygen and in some cases may require some time in the neonatal intensive care unit.
If the tachypnea is due to asthma or COPD, patients can receive an inhaled medicine to dilate and expand the alveoli in obstructive lung disease. If due to pneumonia, the indication is for antibiotics in the treatment of bacterial pneumonia, but viral pneumonia can be treated supportively without antibiotics.
While tachypnea refers to rapid, shallow breathing, other conditions can also be mistaken for tachypnea as they may present similarly. Hyperpnea refers to both rapid and deep breathing, and dyspnea indicates the sensation of shortness of breath.
Tachypnea may be concerning for patients, but it is not always indicative of a critical illness. Though patients often require the advice of a medical professional, there are a variety of causes, and some may need immediate medical care.
While tachypnea can result from physiological causes such as exercise, there are pathologic causes that may be of concern. The complications that arise from these pathologic causes are ones that clinicians should be aware of as they can lead to worsening physical exam and patient care outcomes.
Tachypnea can be a symptom of sepsis or acidosis, such as diabetic ketoacidosis or metabolic acidosis. Patients with lung problems such as pneumonia, pleural effusion, pulmonary embolism, COPD, asthma, or an allergic reaction also present with tachypnea. Congestive heart failure can also be a cause of tachypnea and if not managed, can progress to worsening heart failure.
Anxiety states and hyperventilation during panic attacks would lead to tachypnea and can lead to hypocapnia, or reduced carbon dioxide levels which in turn reduces respiratory drive.
Patients should receive reassurance that tachypnea may not always indicate a serious medical illness. Patient education regarding the cause behind the patient's tachypnea is crucial. Patient understanding of their condition can help in proper management and follow-up of the condition.
If there are any concerns, the safest course of action would be to seek medical advice right away to ensure diagnostic workup and treatment promptly.
As expected, best possible outcomes for patient care involves an integrated and interprofessional team approach that includes an internist, nurse practitioner, pulmonologist, intensivist, and a laboratory specialist. If a patient is seen to be tachypneic, the role of clinical physical exam, imaging and laboratory values are significant. The patient should not be discharged until the tachypnea has resolved and consultations or referrals take place as deemed necessary. Healthcare professionals should discuss amongst themselves any significant complications or comorbidities.
Collaboration and teamwork, as well as communication, are necessary for good outcome and prognosis. This collaboration should involve the entire interprofessional team including all physicians, specialty-trained nurses, and pharmacists or respiratory therapists, profession here appropriate, using an integrated and evidence-based approach to determining the plan and treatment leading to optimal patient care and outcomes. [Level V]
We are looking for contributors to author, edit, and peer review our vast library of review articles and multiple choice questions. In as little as 2-3 hours you can make a significant contribution to your specialty. In return for a small amount of your time, you will receive free access to all content and you will be published as an author or editor in eBooks, apps, online CME/CE activities, and an online Learning Management System for students, teachers, and program directors that allows access to review materials in over 500 specialties.
This is an academic project designed to provide inexpensive peer-reviewed Apps, eBooks, and very soon an online CME/CE system to help students identify weaknesses and improve knowledge. We would like you to consider being an author or editor. Please click here to learn more. Thank you for you for your interest, the StatPearls Publishing Editorial Team.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
|Takayama A,Takeshima T,Nakashima Y,Yoshidomi T,Nagamine T,Kotani K, A Comparison of Methods to Count Breathing Frequency. Respiratory care. 2019 May [PubMed]|
|Asmundsson AS,Arms J,Kaila R,Roback MG,Theiler C,Davey CS,Louie JP, Hospital Course of Croup After Emergency Department Management. Hospital pediatrics. 2019 Apr 15 [PubMed]|
|Chowdhury N,Giles BL,Dell SD, Full-Term Neonatal Respiratory Distress and Chronic Lung Disease. Pediatric annals. 2019 Apr 1 [PubMed]|
The intent of StatPearls is to provide practice questions and explanations to assist you in identifying and resolving knowledge deficits. These questions and explanations are not intended to be a source of the knowledge base of all of medicine, nor is it intended to be a board or certification review of Ob Gyn-Medical Student. The authors or editors do not warrant the information is complete or accurate. The reader is encouraged to verify each answer and explanation in several references. All drug indications and dosages should be verified before administration.
StatPearls offers the most comprehensive database of free multiple-choice questions with explanations and short review chapters ever developed. This system helps physicians, medical students, dentists, nurses, pharmacists, and allied health professionals identify education deficits and learn new concepts. StatPearls is not a board or certification review system for Ob Gyn-Medical Student, it is a learning system that you can use to help improve your knowledge base of medicine for life-long learning. StatPearls will help you identify your weaknesses so that when you are ready to study for a board or certification exam in Ob Gyn-Medical Student, you will already be prepared.
Our content is updated continuously through a multi-step peer review process that will help you be prepared and review for a thorough knowledge of Ob Gyn-Medical Student. When it is time for the Ob Gyn-Medical Student board and certification exam, you will already be ready. Besides online study quizzes, we also publish our peer-reviewed content in eBooks and mobile Apps. We also offer inexpensive CME/CE, so our content can be used to attain education credits while you study Ob Gyn-Medical Student.