Labored respirationis an abnormal respiration characterized by evidence of increased effort to breathe, including the use of accessory muscles of respiration, stridor, grunting, or nasal flaring.^[1] Labored breathing is distinguished from shortness of breath or dyspnea, which is the sensation of respiratory distress rather than a physical presentation.

Presentations of labored respiration include:

• Hyperpnea: faster and/or deeper breathing
• Tachypnea: increased breathing rate
• Retractions or recessions: sucking in of the skin, around the ribs^[2] and the top of the sternum^[3]
• Use of accessory muscles of respiration rather than only the diaphragm

• Cardiac diseases
• Diabetic ketoacidosis
• Metabolic acidosis
• Renal failure
• Respiratory failure