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.
Key wordsPneumonia Hypoxemia Clinical predictors
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- 1.Reducing mortality from major killers of children. WHO Fact sheet No. 178, revised September 1998Google Scholar
- 2.Nepal Demographic and Health Survey 2001,Family Health Division, Department of Health Services. Preliminary Report. September 2001.Google Scholar
- 3.Nepal Ministry of Health,Department of Health Services Annual Report 2000–2001.Google Scholar
- 6.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.Google Scholar
- 10.Smyth A, Carty H, Hart CA. Clinical predictors of hypoxemia in children with pneumonia.Ann Trop Pediatr Mar 1998; 18(1): 31–40.Google Scholar
- 14.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.Google Scholar