RELATIONSHIP BETWEEN PULSE OXIMETRY RESULTS AND PROGNOSIS OF CHILDREN WITH PNEUMONIA

Abstract

Abstract

Introduction: Pulse oximetry is shown to be a reliable indicator of severity of pneumonia in children, and its use is associated with decrease in mortality of pneumonia among children. Also it is a cost-effective tool in management of pneumonia. The general objective of this study is to determine the relationship between pulse oximetry results and prognosis of children with pneumonia.

Methods: This cross-sectional study was carried out on children with respiratory symptoms aged 1 month to 5 years old referring to Bandar Abbas Pediatric Hospital, Iran between January and March 2016. Convenience sampling was used to select the study participants. According to the clinical signs and symptoms, as well as chest radiography, patients were allocated to one of the groups of Pneumonia or Non-Pneumonia. O2 saturation was measured at baseline, using pulse oximetry. The patients were assessed for condition at discharge, oxygen-delivery device, and duration of hospitalization. Independent samples t-test, one-way analysis of variance (ANOVA) and Pearson Correlation were used for data analysis via IBM SPSS version 23.0 software. A p-value less than 0.05 was considered as significant.

Results: In total, 299 patients with a mean age of 14.3 ± 9.83 years were studied in two groups of Pneumonia (n=149) and Control (n=150). Of the two groups, 178 (59.5%) were male and 121 (40.5%) were female. Baseline mean O2 saturation was 97.90 ± 4.60 percent in the pneumonia group and 99.95 ± 0.57 percent in the non-pneumonia group (p < 0.001). Among pneumonia patients, saturation of O2 was significantly lower in the group of patients who died, in comparison to children who were discharged by the physician or by parental consent. (83 ± 8.27 versus 98.17 ± 3.69 and 99.16 ± 2.56; p < 0.001). Results of this study showed that there was significant difference in the saturation of O2 according to oxygen-delivery devices in pneumonia patients (p < 0.001). 

Conclusion: Lower initial O2 saturation is observed in the pneumonia patients in comparison to the control group, in patients with death, in comparison to discharged patients by physician or parental consent. Also, the O2 saturation was significantly different according the oxygen-delivery devices (p < 0.001). Furthermore, lower O2 saturation was associated with longer duration of hospitalization. Therefore, pulse oximetry has good prognostic role in children with pneumonia. We recommend using pulse oximetry in evaluation of children with pneumonia especially in low resource setting.