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Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia

BACKGROUND: In adequately resourced clinical environments, diagnosis of hypoxemia via pulse oximetry is routine. Unfortunately, pulse oximetry is rarely utilized in under-resourced hospitals in developing countries. AIM: The prevalence of undiagnosed hypoxemia among adults and children with illnesse...

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Autores principales: Foran, Mark, Ahn, Roy, Novik, Joseph, Tyer-Viola, Lynda, Chilufya, Kennedy, Katamba, Kasseba, Burke, Thomas
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047821/
https://www.ncbi.nlm.nih.gov/pubmed/21373304
http://dx.doi.org/10.1007/s12245-010-0241-5
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author Foran, Mark
Ahn, Roy
Novik, Joseph
Tyer-Viola, Lynda
Chilufya, Kennedy
Katamba, Kasseba
Burke, Thomas
author_facet Foran, Mark
Ahn, Roy
Novik, Joseph
Tyer-Viola, Lynda
Chilufya, Kennedy
Katamba, Kasseba
Burke, Thomas
author_sort Foran, Mark
collection PubMed
description BACKGROUND: In adequately resourced clinical environments, diagnosis of hypoxemia via pulse oximetry is routine. Unfortunately, pulse oximetry is rarely utilized in under-resourced hospitals in developing countries. AIM: The prevalence of undiagnosed hypoxemia among adults and children with illnesses other than pneumonia in these environments remains poorly described. METHODS: This cross-sectional analysis of the prevalence of hypoxemia was conducted in Kapiri Mposhi, Zambia, at the 60-bed District Hospital, which serves a population of 320,000. The resting room air oxygen saturations of two consecutive samples of all adult and pediatric inpatients were measured in December 2008 and March 2009 using handheld pulse oximetry. Hypoxemia was defined as resting room air SpO(2) less than 90%. RESULTS: A total of 192 patients were enrolled: 68 young children (<5 years old), 15 older children (5–17 years old), and 109 adults (≥18 years old). Five young children (7%), 0 older children (0%), and 10 adults (9%) were hypoxemic. No hypoxemic patients were receiving oxygen therapy at the time of diagnosis. Pneumonia, tuberculosis, and malnutrition were the most common conditions among those with hypoxemia. Oximetry data changed clinical management in all observed cases of hypoxemia and several cases of normoxemia, leading to application of supplemental oxygen, initiation of further diagnostic testing, prolongation of inpatient stay, or expedited discharge home. CONCLUSIONS: Undiagnosed hypoxemia is present among inpatients at this district hospital in rural Zambia with high prevalence in both adults and young children. These results support routine screening for hypoxemia in similar facilities in both age groups. Further investigation is warranted into the clinical impact and cost-effectiveness of pulse oximetry, provision of oxygen concentrators, and training on their use in developing countries.
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spelling pubmed-30478212011-03-03 Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia Foran, Mark Ahn, Roy Novik, Joseph Tyer-Viola, Lynda Chilufya, Kennedy Katamba, Kasseba Burke, Thomas Int J Emerg Med Original Research Article BACKGROUND: In adequately resourced clinical environments, diagnosis of hypoxemia via pulse oximetry is routine. Unfortunately, pulse oximetry is rarely utilized in under-resourced hospitals in developing countries. AIM: The prevalence of undiagnosed hypoxemia among adults and children with illnesses other than pneumonia in these environments remains poorly described. METHODS: This cross-sectional analysis of the prevalence of hypoxemia was conducted in Kapiri Mposhi, Zambia, at the 60-bed District Hospital, which serves a population of 320,000. The resting room air oxygen saturations of two consecutive samples of all adult and pediatric inpatients were measured in December 2008 and March 2009 using handheld pulse oximetry. Hypoxemia was defined as resting room air SpO(2) less than 90%. RESULTS: A total of 192 patients were enrolled: 68 young children (<5 years old), 15 older children (5–17 years old), and 109 adults (≥18 years old). Five young children (7%), 0 older children (0%), and 10 adults (9%) were hypoxemic. No hypoxemic patients were receiving oxygen therapy at the time of diagnosis. Pneumonia, tuberculosis, and malnutrition were the most common conditions among those with hypoxemia. Oximetry data changed clinical management in all observed cases of hypoxemia and several cases of normoxemia, leading to application of supplemental oxygen, initiation of further diagnostic testing, prolongation of inpatient stay, or expedited discharge home. CONCLUSIONS: Undiagnosed hypoxemia is present among inpatients at this district hospital in rural Zambia with high prevalence in both adults and young children. These results support routine screening for hypoxemia in similar facilities in both age groups. Further investigation is warranted into the clinical impact and cost-effectiveness of pulse oximetry, provision of oxygen concentrators, and training on their use in developing countries. Springer-Verlag 2010-11-11 /pmc/articles/PMC3047821/ /pubmed/21373304 http://dx.doi.org/10.1007/s12245-010-0241-5 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Original Research Article
Foran, Mark
Ahn, Roy
Novik, Joseph
Tyer-Viola, Lynda
Chilufya, Kennedy
Katamba, Kasseba
Burke, Thomas
Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title_full Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title_fullStr Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title_full_unstemmed Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title_short Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia
title_sort prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in zambia
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047821/
https://www.ncbi.nlm.nih.gov/pubmed/21373304
http://dx.doi.org/10.1007/s12245-010-0241-5
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