Literature DB >> 15004298

Can clinical symptoms or signs accurately predict hypoxemia in children with acute lower respiratory tract infections?

Rakesh Lodha1, Prateek Singh Bhadauria, Anoop Verghese Kuttikat, Madhavi Puranik, Saurabh Gupta, R M Pandey, S K Kabra.   

Abstract

OBJECTIVES: To determine clinical predictors of hypoxemia in children with acute lower respiratory tract infection (ALRI).
DESIGN: Cross-sectional study.
SETTING: Emergency department of All India Institute of Medical Sciences, a tertiary care hospital.
SUBJECTS: 109 under five children, with ALRI.
METHODS: Clinical symptoms and signs were recorded. Oxygen saturation was determined by a pulse oximeter. Hypoxemia was defined as oxygen saturation less than 90%. The ability of various clinical symptoms and signs to predict the presence of hypoxemia was evaluated.
RESULTS: Twenty-eight (25.7%) children were hypoxemic. No symptoms were statistically associated with hypoxemia. Tachypnea, suprasternal indrawing, intercostal indrawing, lower chest indrawing, cyanosis, crepitations, and rhonchi were statistically significantly associated with hypoxemia. A simple model using the presence of rapid breathing (> or =80/min in children < or =3 m, > or =70/min in >3-12 m and > or =60/min in >12 m) or lower chest indrawing had a sensitivity of 78.5% and specificity of 66.7% for detecting hypoxemia. No individual clinical symptom/sign or a combination had both sufficient sensitivity and specificity to identify hypoxemia.
CONCLUSION: None of the clinical features either alone or in combination have desirable sensitivity and specificity to predict hypoxemia in children with acute lower respiratory tract infection.

Entities:  

Mesh:

Year:  2004        PMID: 15004298

Source DB:  PubMed          Journal:  Indian Pediatr        ISSN: 0019-6061            Impact factor:   1.411


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