Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease?. (February 2015)

• Record Type: Journal Article
• Authors: Wandeler, G.; Pauchard, J. Y.; Zangger, E.; Diawara, H.; Gehri, M.
• Is Part Of: Paediatrics and international child health. Volume 35:Number 1(2015:Feb.)
• Page Start: 65
• Page End: 68
• Publication Date: 2015-02
• Subjects: Pediatrics -- Developing countries -- Periodicals; Children -- Health and hygiene -- Developing countries -- Periodicals; Children -- Diseases -- Developing countries -- Periodicals; 618.920009172405
• DOI: 10.1179/2046905514Y.0000000153
• Languages: English
• ISSNs: 2046-9047

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>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.</p> </sec> <sec> <title>Objective:</title> <p>To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease.</p> </sec> <sec> <title>Methods:</title> <p>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 &lt;90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR).</p> </sec> <sec> <title>Results:</title> <p>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.</p> </sec> <sec> <title>Conclusion:</title> <p>In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.</p> </sec> </abstract>