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The value of a pulse oximeter

Spotting cyanosis reliably has always been considered to be a clinical challenge for some, especially in children with darker pigmented skins. The pulse oximeter has had a huge impact on clinical medicine and is often thought of as the fifth ‘clinical sign’. Lucina was impressed by this study from Graham H et al. [EClinical Medicine 2019 DOI: https://doi.org/10.1016/j.eclinm.2019.10.009] where they evaluated the epidemiology of hypoxaemia (defined as haemoglobin oxygen saturations of less than 90% as measured by pulse oximetry) and oxygen use in hospitalised neonates and children in Nigeria. This prospective cohort study examined 23 926 neonates and children (<15 years of age) who were admitted to 12 secondary-level hospitals, during a 2 year study period. They identified the prevalence of hypoxaemia, oxygen use, and clinical predictors of hypoxaemia. Using a generalised linear mixed-models they calculated the relative odds of death Surprisingly pooled hypoxaemia prevalence was 22.2% (95%CI 21.2 to 23.2) for neonates and 10.2% (9.7–10.8) for children. Hypoxaemia was common among children with acute lower respiratory infection (28.0%), asthma (20.4%), meningitis/encephalitis (17.4%), malnutrition (16.3%), acute febrile encephalopathy (15.4%), sepsis (8.7%) and malaria (8.5%), and neonates with neonatal encephalopathy (33.4%), prematurity (26.6%), and sepsis (21.0%). …

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