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Respiratory Retractions | Causes | Symptoms | Diagnosis | Treatment

What are Respiratory Retractions?

Respiratory retraction or intercostal respiratory retractions are the drawing in of the muscles in between the ribs when a person inhales. It is an indication that the person is having difficulty getting enough air into the lungs and the pressure in the chest cavity is lower than usual.(1)

It can affect both children and adults and is caused due to medical conditions including asthma, pneumonia, and severe allergic reactions.

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The occurrence of respiratory retraction needs emergency medical attention. The medical intervention involved includes oxygen as well as medications that help in reducing swelling. Once the immediate threat is over, the doctors work to diagnose the underlying condition and treat it.

What Causes Respiratory Retractions

Intercostal muscles are the muscles present in between the ribs. As a person inhales, the muscle tightens and pulls the rib cage up, expanding the chest.

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In those suffering from respiratory retraction, there is difficulty in inhaling causing muscle tightening with more force to breathe in more air. This leads to drawing in of the muscles and tissues present as they suck inwards between the ribs. It can indicate severe respiratory distress due to the low availability of oxygen.

The condition that may lead to respiratory retractions include:

Asthma: It is a chronic lung condition in which the airway narrows and gets inflamed. Respiratory retraction may occur during severe asthma episodes raising the risk of respiratory acidosis.

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Epiglottitis: Epiglottis is cartilage under the tongue that covers the windpipe during swallowing. Inflammation of the epiglottis leads to swelling of the upper airway and cessation of breathing. Intercostal respiratory retraction is the common symptom of severe epiglottitis.(2)

Pneumonia: It is a lung infection that leads to mild to severe illness and can occur in both children and adults. Respiratory retractions if present indicates severe pneumonia.

Severe Allergy: Anaphylaxis is a life-threatening condition. Respiratory retraction is one symptom of severe allergy to food and other substance.

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Croup: It is a common respiratory illness occurring in children. It affects the windpipe, voice box, and airway in the lungs. It can lead to barking cough.(3)

Swallowing a Foreign Object: Sometimes children swallow objects that can lodge into the airway and result in aspiration and asphyxiation. Respiratory retraction may signal respiration distress.(4)

Bronchiolitis: Viral bronchiolitis is a wheezing illness of the upper respiratory tract. It is mostly found affecting children.

Respiratory Distress Syndrome: This condition is known to affect infants before 28 weeks making them work harder to breathe. Retraction is a common symptom of this condition.

Retropharyngeal abscess: It occurs due to the collection of pus in the back of the throat and is a common condition in children below 5 years of age.

Symptoms of Respiratory Retraction

Intercostal respiratory retraction cause the skin and the tissues in between the ribs to pull in and out with each breath. The ribs may get prominent in some. These changes are more noticeable in obese individuals.

Respiratory retractions may be the symptom of respiratory distress and come along with labored breathing. The associated symptoms include:

  • Fast breathing
  • Grunting when breathing out
  • Flaring of nostrils

How are Respiratory Retractions Diagnosed?

No equipment is needed for the diagnosis of respiratory retraction. It can be diagnosed by mere observation.(5)

As several conditions can lead to respiratory retractions, various tests are there that can help in detecting these conditions. These include:

  • Chest x-ray
  • Arterial blood gas test
  • Complete blood count

Treatments for Respiratory Retractions

In case of severe respiratory retraction, emergency help may be needed. This may include providing oxygen and medications.

As the patient is out of danger the doctor may look forward to diagnosing the underlying condition that may be causing the retractions and providing the necessary treatment.

The outlook of respiratory retractions depend on the severity of the condition and whether or not it can be controlled by the treatment. Also in cases of asthma regular monitoring may be required to prevent the recurrence of the condition.

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