Ibraheem R M, Johnson W B, Abdulkarim A A
Department of Paediatrics & Child Health, University of Ilorin Teaching Hospital,Ilorin, Kwara State, Nigeria.
West Afr J Med. 2014 Jan-Mar;33(1):37-43.
Hypoxaemia constitutes a possible complication of severe respiratory illness which is often under-reported in developing countries. Therefore, the current study was carried out to determine the prevalence and clinical predictors of hypoxaemia in hospitalized under-five children with pneumonia in Ilorin, Nigeria.
This is a descriptive cross-sectional study of 200 children aged between two months and five years with pneumonia recruited consecutively. Socio-demographic, clinical and laboratory data were obtained. The pulse oximetry measurement was recorded after a stable reading for at least one minute while the child was breathing room air. Hypoxaemia was defined as an arterial oxygen saturation of less than 90%. Data was analyzed using the SPSS 20.0 software.
The male/female ratio was 1.5:1.The prevalence of hypoxaemia in the children with pneumonia was 41.5%.Using a linear regression analysis, the clinical features that were significantly associated with hypoxaemia were restlessness, lower chest wall indrawing, bronchial breath sounds and tender hepatomegaly (p<0.05 each). Restlessness had a sensitivity of 22.9%, specificity of 91.5%, while chest wall indrawing had a sensitivity of 86.7% and specificity of 53.3%. Bronchial breath sound had a sensitivity of 16.9%, a specificity of 95.7% whereas tender hepatomegaly had a sensitivity of 48.2% and specificity of 82.9%.
There is a high local burden of pneumonia-associated hypoxaemia. Restlessness, chest wall indrawing, bronchial breath sounds and tender hepatomegaly could be useful in detecting pneumonia-related hypoxemia in poorly equipped health facilities.
低氧血症是严重呼吸道疾病的一种可能并发症,在发展中国家往往报告不足。因此,本研究旨在确定尼日利亚伊洛林市五岁以下住院肺炎儿童低氧血症的患病率及临床预测因素。
这是一项描述性横断面研究,连续招募了200名年龄在两个月至五岁之间的肺炎儿童。获取了社会人口学、临床和实验室数据。在儿童呼吸室内空气且读数稳定至少一分钟后记录脉搏血氧饱和度测量值。低氧血症定义为动脉血氧饱和度低于90%。使用SPSS 20.0软件进行数据分析。
男女比例为1.5:1。肺炎儿童中低氧血症的患病率为41.5%。通过线性回归分析,与低氧血症显著相关的临床特征为烦躁不安、下胸壁凹陷、支气管呼吸音和肝脏触痛(每项p<0.05)。烦躁不安的敏感度为22.9%,特异度为91.5%,而下胸壁凹陷的敏感度为86.7%,特异度为53.3%。支气管呼吸音的敏感度为16.9%,特异度为95.7%,而肝脏触痛的敏感度为48.2%,特异度为82.9%。
肺炎相关低氧血症的当地负担很重。烦躁不安、胸壁凹陷、支气管呼吸音和肝脏触痛有助于在设备简陋的医疗机构中检测与肺炎相关的低氧血症。