Overview of tachypnea
Shortness of breath (tachypnea) is a kind of shallow and rapid respiration with a respiratory rate of more than 24 breaths per minute. It is a common clinical respiratory symptom, which is often an early symptom of respiratory disease or respiratory insufficiency due to lesions of organs or tissues controlling and affecting respiration. Further aggravation of the condition may result in respiratory distress or dyspnea, or even respiratory failure, which may be life-threatening. Because of the anatomical and physiological characteristics of the respiratory system, infants are more prone to shortness of breath and respiratory distress once the disease affects their breathing. Treatment is appropriate to find the primary disease that causes shortness of breath, targeting the cause of the disease. Open the airway, improve ventilation and oxygenation.
Causes
Shortness of breath can be caused by a variety of factors, including diseases of the respiratory system itself, or diseases of the central nervous system, cardiovascular system, abdominal cavity, gastrointestinal tract, metabolism, endocrine system, and blood system. Shallow fast breathing is seen in respiratory muscle paralysis, severe tympanites, ascites and obesity, as well as lung diseases such as pneumonia, pleurisy, pleural effusion and pneumothorax. Deep and fast breathing is seen in strenuous exercise, because the body’s oxygen supply increases the need to increase the gas exchange in the lungs. In addition, when emotional excitement or excessive tension, also often appear deep fast breathing, and hyperventilation phenomenon, at this time the arterial blood carbon dioxide partial pressure is reduced, resulting in respiratory alkalosis, the patient often feel numbness around the mouth and limbs, severe cases can occur hand and foot convulsions and apnea. When severe metabolic acidosis, also appear deep and slow breathing, this is due to the extracellular fluid bicarbonate insufficient, the pH is reduced, through the lungs to discharge CO2, compensation, in order to regulate the extracellular acid-base balance of the reason, see diabetes mellitus ketoacidosis and uremia acidosis, etc., this kind of deep and long breathing is also known as the Kushmore (Kussmaul) respiration.
Examination
A thorough history taking and physical examination will usually provide information about the probable site and etiology of the lesion. In addition to respiratory rate, depth, rhythm, symmetry, respiratory effort (respiratory muscle work), and lung auscultation, the physical examination includes a general response, state of consciousness, vital signs (heart rate, pulse rate, blood pressure, temperature, etc.), and circulatory perfusion, which provide an indication of the severity of the disease. Tests such as peak expiratory flow rate (PEFR), breath-hold test, and respiratory muscle function measurements are performed when necessary.
Differential diagnosis
1. Asthma
Asthma is usually characterized by shortness of breath and usually occurs at night.
2. Emphysema
Chronic obstructive pulmonary disease (COPD) often causes shortness of breath with exertional dyspnea, peripheral cyanosis, nodding respiration, labored breathing, and chronic sputum.
3. Cardiac arrhythmia
Arrhythmia can be characterized by weakness, lowered blood pressure, palpitations, shortness of breath, and dizziness.
4. Hypoxemia
Lack of oxygen causes shortness of breath (and usually deepening of breath).
5. Febrile illness
Febrile illnesses can cause tachycardia, shortness of breath, and other signs.
Principles of treatment
Identify the cause of the illness and provide targeted treatment. Although the cause varies, the initial aggressive treatment is the same, i.e., opening the airway, improving ventilation and oxygenation.