title: [Diagnostic assessment of head nodding in hypoxemia in children with pneumonia].
abstract: OBJECTIVE
  To assess the clinical usefulness of the head nodding sign (HN) in children with pneumonia.
  
  
  METHODS
  Cross-sectional study that included 62 children aged 2-59 months. Hypoxemia was defined as arterial oxygen saturation <94% measured by pulse oximetry. HN was examined with regard to three levels of hypoxemia (<94%, <or= 90%, <or= 84%).
  
  
  RESULTS
  The overall prevalence of hypoxemia was 56.5 %. HN was observed in 64.5% (40) of the patients, 48.4% (30) of those had pneumonia and 73.1% were hypoxemic. HN showed a sensitivity of 73.2% and a specificity of 52.4%. Accuracy of HN was better when a cut off level <94% was used. HN in infants was a better index for hypoxemia than for older children.
  
  
  CONCLUSIONS
  HN was a good predictor of hypoxemia in children with pneumonia. It seems that HN is an easily recognizable sign, and it could be easily taught to parents and health workers.
authors.affiliation: Servicio de neonatología, Hospital Infantil del Estado de Sonora, Hermosillo, Sonora, México. tmx6622173381@prodigy.net.mx
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martínez-Medina
authors.forename: Gerardo
authors.initials: G
authors.lastname: Alvarez-Hernández
authors.forename: Ana B
authors.initials: AB
authors.lastname: Contreras-Mendoza
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D019416:Head Movements; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000209:etiology*; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000150:complications*; D015203:Reproducibility of Results