Which retraction patterns are usually observed in severe lower airway obstruction?

Seesaw respirations are characterized by the paradoxical movement of the abdomen and chest during breathing, where the chest moves inward while the abdomen moves outward, or vice versa. This pattern typically indicates a significant respiratory distress, often seen in cases of severe lower airway obstruction, such as in asthma or severe bronchospasm.

In this condition, the child struggles to breathe effectively against the obstructed airway, leading to the utilization of accessory muscles and altered mechanics of breathing. The seesaw pattern highlights the severity of the respiratory compromise, as the body attempts to compensate for the inadequate ventilation.

Other patterns such as tracheal tug, classical retractions, and substernal retractions may be less indicative of severe lower airway obstruction. Tracheal tug is more associated with conditions affecting the trachea, while classical and substernal retractions often indicate less severe obstructive scenarios. Therefore, observes a seesaw respiratory pattern is a critical clinical sign in the context of severe lower airway obstruction.