Pulse oximetry to detect paediatric hypoxaemia-the fifth vital sign.
Pulse oximetry to detect paediatric hypoxaemia-the fifth vital sign.
复制标题
脉搏血氧饱和度检测儿童低氧血症——第五个生命体征。
DOI：
10.1016/s2214-109x(23)00380-7
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
McCollum,EricD
中科院分区：
文献类型：
--
作者：
Zar,HeatherJ;McCollum,EricD
肺炎或下呼吸道感染仍然是5岁以下儿童发病率和死亡率的主要原因，2019年约672 000名儿童肺炎死亡中的大多数发生在低收入和中等收入国家。1几乎所有儿童肺炎死亡都是可预防或可治疗的；重要的死亡风险因素包括低氧血症(脉搏血氧仪测量的低外周动脉血氧饱和度)、营养不良、贫血或潜在的慢性病。儿童肺炎的死亡是由于对疾病严重程度、死亡风险以及缺乏适当、及时的治疗，包括医用氧气的认识不足所致。在LMICs中，四种生命体征被用来评估儿童疾病的严重程度：心率、呼吸频率、血压和体温。其中，根据世卫组织儿童疾病综合管理指南(IMCI)，只有呼吸率用于肺炎管理，这是LMICS三十年来儿童肺炎管理的支柱。世卫组织IMCI指南建议对严重肺炎使用抗生素和医院转诊，或对非严重肺炎建议使用口服抗生素的家庭护理。在没有血氧测定仪的情况下，这种分类主要依靠临床敏锐度。
Pneumonia or lower respiratory infection remains a major cause of morbidity and mortality in children younger than 5 years, with most of the approximately 672 000 childhood pneumonia deaths in 2019 occurring in low-income and middle-income countries (LMICs). 1 Almost all childhood pneumonia deaths are preventable or treatable; important mortality risk factors include hypoxaemia (low peripheral arterial oxyhaemoglobin saturation [SpO2] measurement by pulse oximetry), malnutrition, anaemia, or underlying chronic conditions. Childhood pneumonia death is driven by inadequate recognition of illness severity, mortality risk, and lack of appropriate, timely treatment, including medical oxygen.In LMICs, four vital signs are used to assess childhood illness severity: heart rate, respiratory rate, blood pressure, and temperature. Of these, only respiratory rate is utilised for pneumonia management per WHO Integrated Management of Childhood Illness (IMCI) guidelines, the backbone of childhood pneumonia management for three decades in LMICs. WHO IMCI guidelines recommend antibiotics and hospital referral for severe pneumonia or home-based care with oral antibiotics for non-severe pneumonia. 2 In the absence of oximetry, such categorisation rests predominantly on clinical acumen.