Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease?

Wandeler, Gilles; Pauchard, J Y; Zangger, E; Diawara, H; Gehri, M (2015). Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease? Paediatrics and international child health, 35(1), pp. 65-68. Maney Publishing 10.1179/2046905514Y.0000000153

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BACKGROUND Acute lower respiratory tract diseases are an important cause of mortality in children in resource-limited settings. In the absence of pulse oximetry, clinicians rely on clinical signs to detect hypoxaemia. OBJECTIVE To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease. METHODS Seventy children with a history of cough and signs of respiratory distress were enrolled. Three experienced physicians recorded clinical signs and oxygen saturation by pulse oximetry. Hypoxaemia was defined as oxygen saturation <90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR). RESULTS There was a 43% prevalence of hypoxaemia. An initial visual impression of poor general status [aDOR 20·0, 95% CI 3·8-106], severe chest-indrawing (aDOR 9·8, 95% CI 1·5-65), audible grunting (aDOR 6·9, 95% CI 1·4-25) and cyanosis (aDOR 26·5, 95% CI 1·1-677) were significant predictors of hypoxaemia. CONCLUSION In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Wandeler, Gilles

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

2046-9055

Publisher:

Maney Publishing

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

10 Feb 2015 10:07

Last Modified:

12 Sep 2017 16:25

Publisher DOI:

10.1179/2046905514Y.0000000153

PubMed ID:

25547179

Uncontrolled Keywords:

Acute lower respiratory disease, Hypoxaemia, Pulse oximetry Under-5 children,

BORIS DOI:

10.7892/boris.62017

URI:

https://boris.unibe.ch/id/eprint/62017

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