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Clinical Predictors of Hypoxemia in Children with Acute Lower Respiratory Illness

Author Affiliations

  • 1 Department of Pediatrics, CM Medical College, Durg (C.G), INDIA
  • 2 Department of Pediatrics, KKCTH, Chennai, INDIA
  • 3 Department of Community Medicine, Government Medical College, Rajnandgaon, C.G., INDIA

Int. Res. J. Medical Sci., Volume 3, Issue (3), Pages 11-15, March,28 (2015)


Background: Acute lower respiratory illness (ALRI) contributes to significant mortality in developing countries and majority of this is secondary to hypoxemia. Early detection of hypoxemia and treatment improves outcome in these children. As pulse oximeter is not available in all health facilities in developing countries, clinical signs which predict hypoxemia should be identified. This study was done to assess the clinical predictors of hypoxemia in ALRI. A total of 204 children aged between 2-60 months, who were admitted with ALRI in emergency dept. of Kanchi Kamakoti Childs Trust Hospital (KKCTH) were studied. Clinical signs such as tachypnea, chest wall retractions, wheeze, crepitations, head nodding, cyanosis, poor feeding, grunt and impaired consciousness were recorded. Oxygen saturation of these children was recorded separately. Out of 204 children, 81 (39.7%) had hypoxemia. Of these, the prevalence of hypoxemia was noted in 57 infants (42.2%) and 24 children (34.8%) aged 12-59 months. Tachypnea had maximum sensitivity (88%).Chest wall Retractions (70%) and crepitations (73%) had fair sensitivity while specificity for these was 55% each. Signs such as poor feeding, grunt, cyanosis and head nodding had good specificity in predicting hypoxemia. None of the clinical signs of respiratory distress had all the attributes of a good predictor of hypoxemia. Clinical signs and symptoms such as chest wall retraction, inability to feed, grunting and cyanosis may be used by health workers to allow rational use of oxygen in places where there is shortage of oxygen and pulse-oximeter is not available.


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