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1- DDU Hospital , sidcapricorn2101@gmail.com
2- DDU Hospital
Abstract:   (219 Views)
Background: Cases of severe pneumonia in children carry a grave prognosis. Clinical presentations and hypoxemia have shown a significant association with mortality.
Objectives: To determine the risk association between pulse oximetry and clinical parameters.
Methods: The observational cross-sectional study was conducted from March 2018 to December 2019. The children aged two months to 5 years were consecutively selected who presented with a diagnosis of Severe Pneumonia or Very Severe Disease as per IMNCI guidelines. Hypoxemia was defined as oxygen saturation <90%. Univariate and multivariate logistic regression was used to find out the odds ratio of variables to predict hypoxemia. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of signs and symptoms was calculated to predict hypoxemia.
Results: Of 400 children enrolled in the study, 159 (39,75%) children were hypoxemic. Cough, cyanosis, intercostal retractions, nasal flaring, grunting, and lethargy were found to be independent risk factors of hypoxemia with an adjusted odds ratio of 3.13, 213.562, 29.178, 57.762, 179.648 and 19.417, respectively. Predictors that carried a high sensitivity for predicting hypoxemia were breathing difficulty (99.37%), intercostal retractions (98.64%), subcostal retractions (98.76%), nasal flaring (99.37%), lethargy (96.86%) and crepitations (99.87%); and those that had high specificity were convulsion (98.53%), cyanosis (97.99%), suprasternal retractions (99.59%), grunting (97.78%) and head nodding (99.17%).
Conclusion: The study provides conclusive results of the risk association of clinical features in predicting hypoxemia in children with severe pneumonia. The easy use of pulse oximeter and significant association of clinical features with hypoxemia may be useful in the clinical practice for better categorisation, diagnosis, and management of children with severe pneumonia.
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Type of Study: Original Article | Subject: Pediatrics
Received: 2021/05/22 | Accepted: 2021/08/4

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