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Hypoxemia in children with pneumonia and its clinical predictors

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Abstract

Objectives

To assess the prevalence of hypoxemia in children, 2 months to 5 years of age, with pneumonia and to identify its clinical predictors.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Pediatrics, Department of Community Medicine and Family Health, EPC 376, GPO Box 8975, Kathmandu, Nepal

    Sudha Basnet & Ramesh Kant Adhikari

  2. Department of Pediatrics, Institute of Medicine, Kathmandu, Nepal

    Chitra Kumar Gurung

Authors
  1. Sudha Basnet
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  2. Ramesh Kant Adhikari
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  3. Chitra Kumar Gurung
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Correspondence to Sudha Basnet.

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Basnet, S., Adhikari, R.K. & Gurung, C.K. Hypoxemia in children with pneumonia and its clinical predictors. Indian J Pediatr 73, 777–781 (2006). https://doi.org/10.1007/BF02790384

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