Hypoxemia and clinical predictors among children with respiratory distress admitted to University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia 2021.

Abstract

Abstract Introduction: Hypoxemia is defined as a condition where the arterial oxygen tension is below normal. It is a common complication of childhood infections, particularly respiratory tract infections, and non-respiratory infections. Children who suffer from hypoxemia in lower acute respiratory infection have a five-fold increased risk of death compared to children without hypoxemia. Because of this impact, early detection of hypoxemia is a very crucial step to prevent its complication. In addition, there is limited evidence about hypoxemia and clinical predictors in Ethiopia. Objectives: To assess the prevalence and clinical predictors of hypoxemia among children with respiratory distress admitted to the University of Gondar Comprehensive Specialized Hospital. Methods: Institutional based prospective cross-sectional study was conducted from December 2020 to May 2021 among children admitted with respiratory distress in Gondar University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. 399 study participants were selected using systematic random sampling. A structured, pretested, and intervieweradministered

questionnaire was used to collect the data. The arterial oxygen saturation of the child was measured by general physicians and residents using Masimo rad -5 pulse oximetry. Data were first coded and entered using EPI info version 7.1 for data exploration and cleaning. The cleaned data was exported to SPSS version 21 statistical packages for statistical analysis regression, specificity, and sensitivity. Result: In this study, we found that the prevalence of hypoxemia among children admitted with respiratory distress was 63.5% with a response rate of 96.74%. The clinical signs and symptoms significantly associated with hypoxemia were inabilities to feed (AOR: 0.13, 95% CI; 0.02-0.77), head-nodding (AOR: 4.1, 95% CI; 1.81- 9.28), and chest indrawing (AOR: 3.08, 95% CI; 1.32- 7.16). The best sensitive predictors of hypoxemia were fast breathing with sensitivity (98.4%), nasal flaring (100.0%), chest indrawing (83.6%), and intercostals retraction (93.1%). The best specific predictors of hypoxemia were breathing difficulty with specificity (79.4%), Inability to feed (100.0%), wheezing (83.0%), cyanosis (98.6%), impaired consciousness (94.2%), headnodding (88.7%), and supra-sternal retraction (96.5%). Conclusion and recommendation: The prevalence of hypoxemia among children admitted to the pediatrics ward was high. The statistically significant predictors of hypoxemia were inability to feed, head nodding, and chest indrawing. It is recommended to provide immediate care for the patient with respiratory distress and the health care stakeholders better to design appropriate preventive strategies particularly for those patients with the most specific clinical predictors. Keywords: Hypoxemia, Respiratory distress, clinical predictors, Northwest Ethiopia