Vol. 5, Issue 1, Part A (2023)

Aim: The aim of this study was to study clinical predictors of hypoxemia in patients of acute lower respiratory infections in children.

Material & Methods: The observational prospective study was conducted in the General Pediatric Ward and Pediatric Intensive Care Unit of a tertiary care hospital. This was a hospital-based study completed for 1 year. The sample size taken for this study was 100. All children admitted with acute lower respiratory tract infections between the age group of 2 month to 5 years of age and diagnosed with pneumonia or bronchiolitis were included in the study.

Results: A total of 100 cases were enrolled in the study, out of which 70 were male and 30 were female. Out of the 100 cases enrolled, 48 were below the age of 12 months and 52 were above 12 months of age. The mean age was 16.4 months. The most common and significant symptoms were rapid breathing and difficulty breathing. The least common symptom was noisy breathing and pain in the abdomen. Tachypnea (88%), pallor (86%) and nasal flaring (80%), crepitations (added sounds), and subcostal retractions had better sensitivity for detecting hypoxemia. However, these signs had low specificity for hypoxemia. Head nodding (95%), intercostal retractions (82%), and cyanosis (85%) were highly specific for predicting hypoxemia. Males 68 out of 70 were significantly more hypoxemic than females 27 out of 30. Most cases have moderate hypoxemia which includes 80%. 35 cases out of the total 100 were diagnosed to have bronchiolitis, whereas 65 cases had pneumonia.

Conclusion: It was observed that a combination of clinical signs and symptoms can be used to predict hypoxemia when facilities of pulse oximetry and arterial blood gas analysis are not available, especially in low-resource settings.