👶 Downes Score (Neonatal Respiratory Distress)
Assess neonatal respiratory distress severity with the Downes score.
Clinical takeaway
≥ 7 suggests respiratory failure.
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When to use
Decide on escalation of neonatal respiratory support.
How it works
Respiratory rate, cyanosis, air entry, grunting and retractions — each 0–2. ≤ 3 mild, 4–6 moderate, ≥ 7 failure.
Key points
- ≥ 7 suggests respiratory failure.
- Applicable to term/late-preterm infants.
- Use with blood gas where available.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
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.
Frequently asked 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.）