Relación entre signos clínicos e hipoxemia en niños menores de 5 años con enfermedad respiratoria aguda baja

R, Stella Gutiérrez; Compian, Susana; C, Marino; C., Ana María Ferrari

doi:10.4067/s0370-41062001000500005

Cited by 1 publication

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“…For example, Dyke and colleagues found the sensitivity of chest in-drawing to be 98% and its specificity to be just 7%, whereas Gutierrez and colleagues found them to be 59% and 63% respectively [32,34]. These figures do not improve much when using multiple signs; although sensitivity can be increased, it is often at the expense of unacceptable specificity.…”

Section: Resultsmentioning

confidence: 99%

“…Numerous studies have been conducted into the sensitivity and specificity of these clinical signs in the detection of hypoxemia [ 26 , 31 - 33 ] and wide variability has been found in the reported accuracies. For example, Dyke and colleagues found the sensitivity of chest in-drawing to be 98% and its specificity to be just 7%, whereas Gutierrez and colleagues found them to be 59% and 63% respectively [ 32 , 34 ]. These figures do not improve much when using multiple signs; although sensitivity can be increased, it is often at the expense of unacceptable specificity.…”

Section: Resultsmentioning

confidence: 99%

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An evaluation of oxygen systems for treatment of childhood pneumonia

et al. 2011

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BackgroundOxygen therapy is recommended for all of the 1.5 – 2.7 million young children who consult health services with hypoxemic pneumonia each year, and the many more with other serious conditions. However, oxygen supplies are intermittent throughout the developing world. Although oxygen is well established as a treatment for hypoxemic pneumonia, quantitative evidence for its effect is lacking. This review aims to assess the utility of oxygen systems as a method for reducing childhood mortality from pneumonia.MethodsAiming to improve priority setting methods, The Child Health and Nutrition Research Initiative (CHNRI) has developed a common framework to score competing interventions into child health. That framework involves the assessment of 12 different criteria upon which interventions can be compared. This report follows the proposed framework, using a semi-systematic literature review and the results of a structured exercise gathering opinion from experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies), to assess and score each criterion as their “collective optimism” towards each, on a scale from 0 to 100%.ResultsA rough estimate from an analysis of the literature suggests that global strengthening of oxygen systems could save lives of up to 122,000 children from pneumonia annually. Following 12 CHNRI criteria, the experts expressed very high levels of optimism (over 80%) for answerability, low development cost and low product cost; high levels of optimism (60-80%) for low implementation cost, likelihood of efficacy, deliverability, acceptance to end users and health workers; and moderate levels of optimism (40-60%) for impact on equity, affordability and sustainability. The median estimate of potential effectiveness of oxygen systems to reduce the overall childhood pneumonia mortality was ~20% (interquartile range: 10-35%, min. 0%, max. 50%). However, problems with oxygen systems in terms of affordability, sustainability and impact on equity are noted in both expert opinion scores and on review.ConclusionOxygen systems are likely to be an effective intervention in combating childhood mortality from pneumonia. However, a number of gaps in the evidence base exist that should be addressed to complete the investment case and research addressing these issues merit greater funding attention.

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Section: Resultsmentioning

confidence: 99%