A Study of Profile of Children aged 2 months to 5 years admitted with tachypnoea
 
Dr. Murtaza Makati1*, Dr. Zainab Laxmidhar2, Dr. Mohamed Ayaan Sait3
1 3rd Year Paediatric Resident, Narendra Modi Medical College, Ahmedabad, Gujarat, India
Email: murtazamakati69@gmail.com
2 MD Respiratory Medicine, Senior Resident, Respiratory Medicine Department, Shantaba Medical College, Amreli, Gujarat, India
Email: Zainab110laxmidhar@gmail.com
3 Medical Officer, SVP Hospital, Ahmedabad, Gujarat, India
Email: ayaan.sait@gmail.com
Abstract - Tachypnea can be the presentation of multiple different pathologies.A focused history and physical exam,along with an understanding of the pathophysiology of appropriate disease states,can lead to thorough evaluation and management at the bedside. Tachypnea may not be present in respiratory illness only, but also in cardiological causes, underlying neurological disorders, metabolic disorders, sepsis, haematological conditions leading to severe anaemia.
The aim of this study: The aim of this study is to find out the occurrence and clinical profile of tachypnea in hospitalised children from 2 months to 5 years of age.
Study design: The study is designed to be a descriptive observational study conducted over a period of year among children aged 2 months to 5 years admitted at a tertiary care hospital.Out of 846 total admission 145 had tachypnoea. Overall occurrence of tachypnoea was 17.13%
Observation: Occurance of tachypnoea among 2 months to 12 months was 24.53% and 13 months to 60 months was 11.13 %,more number of infants were suffering from tachypnoea owing to the infantile respiratory anatomy they have.More deaths were observed in infantile age group.
Acute respiratory tract infection (N=107 )( 73.79%)is the most common cause of tachypnea among which, pneumonia was the most common cause of tachypnoea constituting 57 patients (53.27 %) , Severe anaemia with Congestive Cardiac Failure was 2nd most common cause- 8.96% and shock constituted 3rd leading cause of tachypnea with 7.58%, underlying cardiac causes constituted-5. 51 %, underlying neurological causes constituted-4.13%, metabolic causes (DKA) constituted- 1.37%.
Keywords: Tachypnea, children

INTRODUCTION

Tachypnea can be the presentation of multiple different pathologies.A focused history and physical exam,along with an understanding of the pathophysiology of appropriate disease states,can lead to thorough evaluation and management at the bedside.

Tachypnea may not be present in respiratory illness only, but also in cardiological causes, underlying neurological disorders, metabolic disorders, sepsis, hematological conditions leading to severe anaemia
 
So we undertook the study to find out the underlying causes co morbid condition and outcome of tachypnea in hospitalized children between the age group of 2 months to 60 months in a tertiary care hospital.Clinical profile of patients having tachypnoea in tertiary care hospitals reflects the burden in the community and identifying the risk factors for mortality and morbidity in the children between 2months to 60 months, will help proper utilisation of available resources and ensure adequate management of these children. Aim of this study was to identify the various causes of tachypnoea among 2months to 60 months old and to analyse various factors influencing morbidity and mortality patterns among them.
CRITERIA FOR TACHYPNOEA

AIMS AND OBJECTIVES

MATERIALS AND METHODOLOGY
Study Area : Paediatric ward of tertiary care hospital
Population : All indoor patients between 2months to 5years
Period : OCTOBER 2020 to MARCH 2021
Study Duration : 6 Months
Study Design : It is a Descriptive observational study
Inclusion Criteria : All hospitalized children 2 months to 5 years presented with Tachypnoea according to IMNCI definition.
Exclusion Criteria : Those having physiological causes of tachypnea like fever induced, anxiety provoked, hysteria etc were excluded.
Its fulfilling the inclusion criteria were admitted in the paediatric ward with tachypnoea were included in the study after taking consent from relatives.
Data were analysed as per standard statistical analytical method.
 
Table 1: Age Distribution in Patients with Tachypnoea
AGE
TOTAL NUMBER (N=145)
%
% SABINETAL
2 MONTHS TO 12 MONTHS
93
64.14℅
56.5℅
13 MONTHS TO 60 MONTHS
52
35.86℅
43.5℅
P VALUE
SIGNIFICANT
The p value is <0.0001 .The result is significant at p<.05

Table 2: Outcome Vs Age

OUTCOMES (N= )
DEATH
PERCENTAGE
2 MONTHS TO 12 MONTHS
3
3.22℅
13 MONTHS TO 60 MONTHS
1
1.92%
P VALUE
SIGNIFICANT
The value of p is <0.0001. The result is significant at p<0.05
Table 3: Gender Distribution in Patients with Tachypnoea
GENDER
NO. OF PATIENTS (N= )
%
% IN SABIN ET ALL
MALE
90
62.06℅
61℅
FENALE
55
37.93%
39%
P VALUE
SIGNIFICANT
The value of p is <0.0001.The result is significant at p<0.05
Table 4: Etiological Causes of Tachypnoea
 
ETIOLOGICAL CAUSES
NUMBER OF PATIENTS
%(N=NO. OF CAESES IN SYSTEAM INVOLVED)
RESPIRATORY CAUSES
BRONCHIOLITIS
30
28.03%
WALRI
10
9.34%
CROUP
4
3.73%
PNEUMONIA
57
53.27%
PLEURAL EFFUSION
1
0.93%
ASTHAMA/HRAD
5
4.67%
SEVERE ANEMIA (N= OUT OF) ( 8.96 % )
SEVERE ANEMIA WITH CCF
13
-
CARDIOLOGICAL CAUSE
(N= out of ) (%)
ASD
1
12.5%
VSD
2
25%
PDA AND PFO
2
25%
TOF AND POF
2
25%
OTHERS (VENTRICULAR HYPERTROPHY)
1
12.5%
SHOCKj=11 OUT OF 145 (7.58%)
CARDIOGENIC SHOCK
0
-
SEPTIC SHOCK
5
46.45%
 
 
 
MISC(N= 4 OUT OF 145) (2.75℅)
POST COVID MISC
4
-
METABOLIC ACIDOSIS (N=2 OUT OF 145) (1.37 ℅)
DIABETIC KETOACIDOSIS
2
-
 
Table 5: Number of Patients Requiring Respiratory Support
RESPIRATORY SUPPORT
NO. OF PATIENTS (N= 145 )
PERCENTAGE
YES
14
9.65%
NO
31
90.36%

 

Table 6 : Outcome of Patients Requiring Respiratory Support

OUTCOME (N= 145)
PERCENTAGE
DEATH
4(28.57%)
DISCHARGE
10(71.43%)
 
CONCLUSION
Out of 846 total admission 145 had tachypnoea. Overall occurance of tachypnoea was17. 13 %. Occurance of tachypnoea among 2 months to 12 months was 24.53% and 13 months to 60 months was 11.13 %,more number of infants were suffering from tachypnoea owing to the infantile respiratory anatomy they have.More deaths were observed in infantile age group. More males (62.06% ) were involved than females(37.93%).
Acute respiratory tract infection (N=107 )( 73.79 %)is the most common cause of tachypnea among which, pneumonia was the most common cause of tachypnoea constituting 57 patients (53.27 %) Severe anaemia with Congestive Cardiac Failure was 2nd most common cause- 8.96% and shock constituted 3rd leading cause of tachypnea with 7.58%, underlying cardiac causes constituted- 5.51 %, underlying neurological causes constituted- 4.13%, metabolic causes (DKA) constituted-1.37%.
It was observed in our study that, out of total 14 children who required ventilatory support, 10 patients had survived and 4 had expired. Mechanical ventilation has helped 71.43% critical children admitted with tachypnea to survive.
Tachypnea remains as single most important bed side sign to predict mortality in children of less than 5 years of age. Early identification, referral and treatment will improve the outcome.
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