In children aged 2-59 months with pneumonia, which clinical signs best predict hypoxaemia?

The World Health Organization (WHO) has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO's recommendations. The WHO guidelines, and more reviews are available at: http://www.ichrc.org. This review addresses the question: In children aged 2-59 months with pneumonia, which clinical signs best predict hypoxaemia? The WHO Pocketbook of Hospital Care for Children recommends that very severe pneumonia is defined as cough or difficulty breathing and at least one of: cyanosis, severe respiratory distress, inability to drink or vomiting everything, or lethargy/ unconsciousness/convulsions, and that severe pneumonia is defined as cough or difficulty breathing plus one of: lower chest indrawing, nasal flaring, grunting.

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