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According to the most recent Unicef estimates, 5.9 million children under age 5 died in 2015.1 In low-income countries, mortality in early childhood is dominated by prematurity, sepsis, and pneumonia—diseases that frequently result in hypoxemic respiratory failure. Since the introduction of pulse oximetry into clinical practice in the 1980s, pulse oximeters have become ubiquitous in high-income countries and are increasingly used in the diagnosis and management of childhood disease in middle and low-resource settings. There is intuitive appeal of a point-of-care device such as pulse oximetry to detect hypoxaemia, particularly in first-level healthcare facilities staffed by minimally trained health workers. However, it is prudent to examine the evidence regarding its use in clinical management and effect on outcomes, particularly in childhood pneumonia.
In this month's issue, Enoch et al2 evaluate the evidence underlying the assertion that pulse oximeters …