Wandeler G, Pauchard JY, Zangger E, Diawara H, Gehri M. Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease?
Paediatr Int Child Health 2015;
35:65-8. [PMID:
25547179 DOI:
10.1179/2046905514y.0000000153]
[Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
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.
Collapse