Intercostal retraction

The inward displacement of the intercostal muscles and skin during inspiration due to markedly increased negative intrathoracic pressure, indicating increased work of breathing and usually associated with significant airway obstruction or respiratory distress.

Causes

• Airway obstruction

  • Foreign body aspiration

  • Anaphylaxis causing airway narrowing

  • Upper airway obstruction

  • Severe airway inflammation

• Obstructive airway diseases

  • Asthma exacerbation

  • Severe bronchospasm

  • Chronic obstructive pulmonary disease (COPD)

• Infectious respiratory causes

  • Croup (viral laryngotracheobronchitis)

  • Bronchiolitis

  • Pneumonia

• Acute lung injury and respiratory failure

  • Acute respiratory distress syndrome (ARDS)

  • Severe pulmonary inflammation

  • Pulmonary edema

• Respiratory muscle fatigue