Effects of high altitude on respiratory rate and oxygen saturation reference values in healthy infants and children younger than 2 years in four countries: a cross-sectional study

Publication date: March 2020Source: The Lancet Global Health, Volume 8, Issue 3Author(s): Mary E Crocker, Shakir Hossen, Dina Goodman, Suzanne M Simkovich, Miles Kirby, Lisa M Thompson, Ghislaine Rosa, Sarada S Garg, Gurusamy Thangavel, Eric D McCollum, Jennifer Peel, Thomas Clasen, William Checkley, HAPIN InvestigatorsSummaryBackgroundIn resource-limited settings, pneumonia diagnosis and management are based on thresholds for respiratory rate (RR) and oxyhaemoglobin saturation (SpO2) recommended by WHO. However, as RR increases and SpO2 decreases with elevation, these thresholds might not be applicable at all altitudes. We sought to determine upper thresholds for RR and lower thresholds for SpO2 by age and altitude at four sites, with altitudes ranging from sea level to 4348 m.MethodsIn this cross-sectional study, we enrolled healthy children aged 0–23 months who lived within the study areas in India, Guatemala, Rwanda, and Peru. Participants were excluded if they had been born prematurely (<37 weeks gestation); had a congenital heart defect; had history in the past 2 weeks of overnight admission to a health facility, diagnosis of pneumonia, antibiotic use, or respiratory or gastrointestinal signs; history in the past 24 h of difficulty breathing, fast breathing, runny nose, or nasal congestion; and current runny nose, nasal congestion, fever, chest indrawing, or cyanosis. We measured RR either automatically with the Masimo Rad-97, manually, or both, and measured SpO2 ...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research