title: Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease?
abstract: BACKGROUND
  Acute lower respiratory tract diseases are an important cause of mortality in children in resource-limited settings. In the absence of pulse oximetry, clinicians rely on clinical signs to detect hypoxaemia.
  
  
  OBJECTIVE
  To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease.
  
  
  METHODS
  Seventy children with a history of cough and signs of respiratory distress were enrolled. Three experienced physicians recorded clinical signs and oxygen saturation by pulse oximetry. Hypoxaemia was defined as oxygen saturation <90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR).
  
  
  RESULTS
  There was a 43% prevalence of hypoxaemia. An initial visual impression of poor general status [aDOR 20.0, 95% CI 3.8-106], severe chest-indrawing (aDOR 9.8, 95% CI 1.5-65), audible grunting (aDOR 6.9, 95% CI 1.4-25) and cyanosis (aDOR 26.5, 95% CI 1.1-677) were significant predictors of hypoxaemia.
  
  
  CONCLUSIONS
  In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.
authors.forename: G
authors.initials: G
authors.lastname: Wandeler
authors.forename: J Y
authors.initials: JY
authors.lastname: Pauchard
authors.forename: E
authors.initials: E
authors.lastname: Zangger
authors.forename: H
authors.initials: H
authors.lastname: Diawara
authors.forename: M
authors.initials: M
authors.lastname: Gehri
mesh_terms: D002675:Child, Preschool; D015510:Clinical Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000473:pathology*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000150:complications* / Q000473:pathology; D012675:Senegal
keywords: Acute lower respiratory disease,; Hypoxaemia,; Pulse oximetry; Under-5 children,