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Indian Pediatr. 2004 Feb;41(2):129-35.

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

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  • 1Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India.

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.

PMID:
15004298
[PubMed - indexed for MEDLINE]
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