Hypoxemia in children with pneumonia and its clinical predictors
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To assess the prevalence of hypoxemia in children, 2 months to 5 years of age, with pneumonia and to identify its clinical predictors.
Children between 2–60 months of age presenting with a complaint of cough or difficulty breathing were assessed. Hypoxemia was defined as an arterial oxygen saturation of <90% recorded by a portable pulse oximeter. Patients were categorized into groups: cough and cold, pneumonia, severe pneumonia and very severe pneumonia.
The prevalence of hypoxemia (SpO2 of <90%) in 150 children with pneumonia was 38.7%. Of them 100% of very severe pneumonia, 80% of severe and 17% of pneumonia patients were hypoxic. Number of infants with respiratory illness (p value=0.03) and hypoxemia (Odds ratio=2.21, 95% Cl 1.03, 4.76) was significantly higher. Clinical predictors significantly associated with hypoxemia on univariate analysis were lethargy, grunting, nasal flaring, cyanosis, and complaint of inability to breastfeed/drink. Chest indrawing with 68.9% sensitivity and 82.6% specificity was the best predictor of hypoxemia.
The prevalence and clinical predictors of hypoxemia identified validate the WHO classification of pneumonia based on severity. Age <1 year in children with ARI is an important risk factor for hypoxemia.
- Reducing mortality from major killers of children. WHO Fact sheet No. 178, revised September 1998
- Nepal Demographic and Health Survey 2001,Family Health Division, Department of Health Services. Preliminary Report. September 2001.
- Nepal Ministry of Health,Department of Health Services Annual Report 2000–2001.
- Onyango FE, Steinhoff MCet al. Hypoxemia in young Kenyan children with acute lower respiratory tract infection.BMJ March 1993; 306: 612–614.
- Usen S, Weber M, Mulholland Ket al. Clinical predictors of hypoxemia in Gambian children.BMJ Jan 1999; 318: 86–91.
- Management of the child with a serious infection or severe malnutrition.Guidelines For Care At The First Referral Level In Developing Countries. World Health Organization, 2000.
- Reuland DS, Steinhoff MC, Gilman RHet al. Prevalence and prediction of hypoxemia in children with respiratory infection in the Peruvian Andes.J Pediatr Dec 1991; 119(6): 900–906. CrossRef
- Lozano JM, Steinhoff MC, Ruiz JGet al. Clinical predictors of acute radiological pneumoni aand hypoxemia at high altitude.Arch Dis Child Oct 1994;71(4): 323–327. CrossRef
- Weber MW, Usen S, Palmer Aet al. Predictors of hypoxemia in hospital admissions with acute lower respiratory tract infection in a developing country.Arch Dis Child April 1997; 76: 310–314.
- Smyth A, Carty H, Hart CA. Clinical predictors of hypoxemia in children with pneumonia.Ann Trop Pediatr Mar 1998; 18(1): 31–40.
- Kabra SK, Lodha Ret al. Can clinical symptoms and signs accurately predict the prevalence of hypoxemia in children with acute lower respiratory infections.Indian Pediatrics 2004; 41: 129–135.
- Laman M, Ripa P, Vince Jet al. Can clinical signs predict hypoxemia in Papua New Guinean children with moderate and severe pneumonia.Ann Trop Paediatr 2005; 25: 31–40. CrossRef
- J.M. Lozano Epidemiology of hypoxemia in children with acute lower respiratory tract infection.Int J Tuberc Lung Dis 2001; 5(6): 496–504.
- Regelmann WE, Hill HR, Cates KL, Quie PG. Immunology of the newborn. In: Feigin RD, Cherry JD, eds.Textbook of Pediatric Infectious Diseases. 3rd ed. Philadelphia: WB Saunders Company, Harcourt Brace Jovanovich Inc, 1982 876–887.
- Sehgal V, Sethi GR, Sachdev HPet al. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections.Indian Pediatr Mar 1997; 34(3): 213–219.
- Banajeh SM. Outcome for children under 5 years hospitalized with severe acute lower respiratory tract infections in Yemen: a 5-year experience.J Trop Pediatr Dec 1998; 44(6): 343–346. CrossRef
- Dyke T, Brown N. Hypoxia in pneumonia: better detection and more oxygen needed in developing countries.BMJ Jan 1994; 308: 119–120.
- Usen S, Weber M. Clinical signs of hypoxemia in children with acute lower respiratory infection: indicators of oxygen therapy.Int J Tuberc Lung Dis 2001; 5(6): 505–510.
- Hypoxemia in children with pneumonia and its clinical predictors
The Indian Journal of Pediatrics
Volume 73, Issue 9 , pp 777-781
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