Clinical signs of hypoxaemia in children aged 2 months to 5 years with acute respiratory distress in Switzerland and Senegal.
Détails
ID Serval
serval:BIB_2C84D552DF38
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinical signs of hypoxaemia in children aged 2 months to 5 years with acute respiratory distress in Switzerland and Senegal.
Périodique
Paediatrics and international child health
ISSN
2046-9055 (Electronic)
ISSN-L
2046-9047
Statut éditorial
Publié
Date de publication
05/2018
Peer-reviewed
Oui
Volume
38
Numéro
2
Pages
113-120
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Hypoxaemia is a predictor of pneumonia-related mortality. WHO published recommendations for oxygen therapy based on clinical signs which state that, when oxygen is plentiful, it should be given to children with central cyanosis, inability to drink, severe chest indrawing, RR >70 breaths/min, grunting with every breath (in young infants) or those who display head nodding. These guidelines, however, are based on a few studies only.
To assess the accuracy of combinations of clinical signs which predict hypoxaemia in pre-school children aged 2 months to 5 years with acute respiratory distress in hospitals in Switzerland and Senegal.
This observational study was conducted in four emergency units, two in Switzerland and two in Senegal. Patients aged 2 months to 5 years with acute respiratory distress were eligible for inclusion. Clinical signs were compared with transcutaneous blood saturation levels (SaO <sub>2</sub> ).
About 111 children were assessed, 67 in Switzerland and 44 in Senegal. The prevalence of hypoxaemia was 13%. Twelve models of combined symptoms were analysed. The WHO model, for when oxygen supply is ample, had the highest diagnostic performance with a sensitivity of 0.93 and a specificity of 0.60.
Clinical signs alone are unreliable for the detection of hypoxaemia. The current WHO model, for ample oxygen supply proved to be the best clinical predictor, although a great number of non-hypoxaemic children were unnecessarily treated because of the low specificity of this model.
To assess the accuracy of combinations of clinical signs which predict hypoxaemia in pre-school children aged 2 months to 5 years with acute respiratory distress in hospitals in Switzerland and Senegal.
This observational study was conducted in four emergency units, two in Switzerland and two in Senegal. Patients aged 2 months to 5 years with acute respiratory distress were eligible for inclusion. Clinical signs were compared with transcutaneous blood saturation levels (SaO <sub>2</sub> ).
About 111 children were assessed, 67 in Switzerland and 44 in Senegal. The prevalence of hypoxaemia was 13%. Twelve models of combined symptoms were analysed. The WHO model, for when oxygen supply is ample, had the highest diagnostic performance with a sensitivity of 0.93 and a specificity of 0.60.
Clinical signs alone are unreliable for the detection of hypoxaemia. The current WHO model, for ample oxygen supply proved to be the best clinical predictor, although a great number of non-hypoxaemic children were unnecessarily treated because of the low specificity of this model.
Mots-clé
Hypoxaemia, acute respiratory distress, clinical signs, diagnostic accuracy, pulse oximetry, under-5 children
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/11/2017 10:42
Dernière modification de la notice
20/08/2019 13:11