Blood gas analysis and chest x-ray findings in infants and preschool children with acute airway obstruction.
BACKGROUND
The importance of SaO2 in the assessment of respiratory distress in bronchial asthma has been reported.


OBJECTIVE
To evaluate the correlation between blood gas analysis and chest X-ray lung opacities in young children presenting with acute respiratory symptoms.


METHODS
Eighty patients (43 males and 37 females aged 0.5-24 months; mean+/-SD 9.1+/-7.2 months), either with acute wheezing respiratory symptoms and/or with crackles were enrolled in our study. In all children, blood gas analysis and chest X-rays were performed within 12 h following admission to the emergency department.


RESULTS
In 55 children (68.75%) chest X-rays demonstrated lung opacities. Subjects with normal X-rays had paO2 and SaO2 higher than subjects with lung opacities (p<0.0001 and p=0.0001, respectively). Children with lung opacities almost always presented paO2<80 mm Hg. Sensitivity and specificity for the presence of lung opacities of paO2<80 mm Hg were 81 and 90%, respectively, while sensitivity and specificity of SaO2<95% were 92 and 40%, respectively. paO2<80 mm Hg in association with SaO2<95% had a positive predictive value for the diagnosis of pneumonia of 90.9%.


CONCLUSIONS
Our study suggests that blood gas analysis, particularly paO2, may help in predicting the presence of lung opacities in patients aged less than 2 years. However, chest X-rays may still be needed to define the actual extension of opacities as well as the possible concomitant presence of complications.
Pifferi
Massimo
M
Department of Pediatric, University of Pisa, Italy. m.pifferi@med.unipi.it
Caramella
Davide
D
Pietrobelli
Angelo
A
Ragazzo
Vincenzo
V
Boner
Attilio L
AL
D000208:Acute Disease; D000402:Airway Obstruction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology; D001249:Asthma / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D010100:Oxygen