Iwob stands for increased work of breathing.
When someone experiences increased work of breathing, it means they are using more effort than normal to inhale and exhale. This can be a sign of various underlying respiratory or medical conditions.
Signs and Symptoms of Increased Work of Breathing
Several signs and symptoms can indicate increased work of breathing:
- Increased Respiratory Rate: Breathing faster than the normal rate for age.
- Increased Heart Rate: The body works harder, which can lead to an elevated heart rate.
- Nasal Flaring: Widening of the nostrils during breathing, especially in infants and young children.
- Retractions: Sucking in of the skin between the ribs (intercostal retractions), above the collarbone (supraclavicular retractions), or below the breastbone (substernal retractions) during inhalation.
- Grunting: A noise made during exhalation, often in infants.
- Head Bobbing: Rhythmic nodding of the head with each breath, particularly in infants.
- Accessory Muscle Use: Using muscles in the neck and shoulders to assist with breathing.
- Tripod Position: Leaning forward with hands on knees or a table to maximize lung expansion.
- Diaphoresis (Sweating): Excessive sweating due to increased effort.
- Agitation or Anxiety: Feeling restless or anxious due to difficulty breathing.
- Cyanosis: Bluish discoloration of the skin, lips, or nail beds due to low oxygen levels (a late sign).
Possible Causes of Increased Work of Breathing
Increased work of breathing can result from various medical issues:
- Asthma: Inflammation and narrowing of the airways.
- Bronchiolitis: Viral infection causing inflammation of the small airways in the lungs, common in infants.
- Pneumonia: Infection of the lungs.
- Chronic Obstructive Pulmonary Disease (COPD): A group of lung diseases that block airflow and make breathing difficult.
- Pulmonary Edema: Fluid accumulation in the lungs.
- Pneumothorax: Collapsed lung.
- Foreign Body Aspiration: Object lodged in the airway.
- Upper Airway Obstruction: Blockage in the upper airway (e.g., croup, epiglottitis).
- Heart Failure: Can cause fluid buildup in the lungs.
Evaluation and Treatment
Evaluating increased work of breathing involves assessing vital signs, physical examination, and potentially further diagnostic tests, such as:
- Pulse Oximetry: Measures oxygen saturation in the blood.
- Arterial Blood Gas (ABG): Measures oxygen and carbon dioxide levels in the blood.
- Chest X-ray: Visualizes the lungs.
- Pulmonary Function Tests (PFTs): Assess lung capacity and airflow (typically in older children and adults).
Treatment will depend on the underlying cause but can include:
- Oxygen therapy: Providing supplemental oxygen.
- Bronchodilators: Medications to open up the airways (e.g., albuterol).
- Corticosteroids: Medications to reduce inflammation (e.g., prednisone).
- Antibiotics: If the cause is a bacterial infection (e.g., pneumonia).
- Diuretics: To remove excess fluid from the lungs (e.g., in pulmonary edema).
- Mechanical Ventilation: In severe cases, a machine may be needed to assist or take over breathing.
- Foreign body removal: Procedure to remove an obstruction.
Increased work of breathing indicates a problem that requires medical attention to diagnose and treat the underlying cause effectively.
