, Volume 73, Issue 9, pp 777-781

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.