Silverman index is a score to assess, in the premature infant, the severity of respiratory distress syndrome.
It is most often due to a lack of surfactant (liquid lining the inner surface of alveoli.)
Silverman index depends on several parameters:

  • Balancing thoraco-abdominal inspiration: mobilization of the thorax and abdomen.
  • Indrawing depression abnormal chest wall, visible up to the intercostal spaces (circulation under sternum) during heavy breaths.
  • This draw may also be visible above the sternum (sternal random addition). This phenomenon occurs when the entry of air into the lungs is obstructed by a mechanical obstacle.
  • Funnel xiphoid.
  • Flapping wings of the nose.
  • Grunting.




These parameters are scored from 0 (normal) to 2 (worst condition), with Note 1 for intermediate gravity. The total score ranges from 0 (no respiratory distress) to 10 (maximum distress).
This score is a useful benchmark for assessing the lung function of newborn and its evolution, it depends on the weight and force of the child. There is no specific respiratory distress.

Settings Note: 0 Note: 1 note: 2
Balancing thoraco-abdominal inspiration absent thorax only the abdomen still rises paradoxical breathing
Indrawing on inspiration absent intercostal discrete intercostal above and below the sternal
Funnel xiphoid absent Moderate intense
Flapping wings of the nose absent Moderate intense
Grunting absent perceived to Stethoscope and discontinuous audible and continuous

If the score is below 6 or 7 he indicates respiratory distress may require respiratory assistance determined by the pediatrician.