Downes Score (Neonatal Respiratory Distress) — free guideline decision tool
Assess neonatal respiratory distress severity with the Downes score.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Respiratory rate | < 60 (0) |
|---|---|
| Cyanosis | None (0) |
| Air entry | Good (0) |
| Grunting | None (0) |
| Retractions | None (0) |
→Downes0/10
- Interpretation：Mild — monitor
- Note：≥ 7 suggests respiratory failure and likely need for assisted ventilation/blood gas.
| Respiratory rate | > 80 or apnoea (2) |
|---|---|
| Cyanosis | In 40% FiO₂ (2) |
| Air entry | Barely audible (2) |
| Grunting | Audible without (2) |
| Retractions | Severe (2) |
→Downes10/10
- Interpretation：Severe — respiratory failure
- Note：≥ 7 suggests respiratory failure and likely need for assisted ventilation/blood gas.
Common questions
What is Downes Score (Neonatal Respiratory Distress)?
Assess neonatal respiratory distress severity with the Downes score.
How is Downes Score (Neonatal Respiratory Distress) calculated? What is the core formula?
Respiratory rate, cyanosis, air entry, grunting and retractions — each 0–2. ≤ 3 mild, 4–6 moderate, ≥ 7 failure.
When is Downes Score (Neonatal Respiratory Distress) used?
Decide on escalation of neonatal respiratory support.
What are the key clinical points for Downes Score (Neonatal Respiratory Distress)?
≥ 7 suggests respiratory failure. Applicable to term/late-preterm infants. Use with blood gas where available.
What are the limits and cautions when using Downes Score (Neonatal Respiratory Distress)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Downes Score (Neonatal Respiratory Distress) calculated in practice? Can you show a worked example?
Inputs: Respiratory rate < 60 (0), Cyanosis None (0), Air entry Good (0), Grunting None (0), Retractions None (0) → Result: Downes 0 /10（Interpretation: Mild — monitor, Note: ≥ 7 suggests respiratory failure and likely need for assisted ventilation/blood gas.） Inputs: Respiratory rate > 80 or apnoea (2), Cyanosis In 40% FiO₂ (2), Air entry Barely audible (2), Grunting Audible without (2), Retractions Severe (2) → Result: Downes 10 /10（Interpretation: Severe — respiratory failure, Note: ≥ 7 suggests respiratory failure and likely need for assisted ventilation/blood gas.）
Run Downes Score (Neonatal Respiratory Distress) now
Assess neonatal respiratory distress severity with the Downes score.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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