Respiratory Rate is the Most Neglected Vital Sign that Can Stop Cardiac Arrest

January 2, 2023

Daily recording of vital signs is a standard procedure for monitoring patients in the hospital wards. Two recent multicentre studies the medical documentation of vital signs in hospitals are of very poor standard, especially respiratory rate which is not often recorded, even of patients with acute respiratory conditions. Despite the fact that an abnormal respiratory rate has been indicated to be a very important predictor of serious conditions like cardiac arrest and admission to an intensive care unit.

In 1993, Fieselmann and colleagues deduced that a respiratory rate higher than 27 breaths per minute was the most important predictor of cardiac arrest in hospital wards. Subbe and colleagues found that, in unstable patients, relative changes in respiratory rate were much greater than changes in heart rate or systolic blood pressure. This clearly indicates that the respiratory rate is a much better way of differentiating between stable patients and patients with high risk factors.

Goldhill and colleagues reported that 21% of admitted patients with a respiratory rate of 25–29 breaths/minute assessed by a critical care outreach service died in hospital. Those with a higher respiratory rate had an even higher mortality rate.

This journal detects how respiratory rate being the most important vital sign is the most neglected when it comes to early disease detection.

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