Hypoxaemia and risk of death among children: rethinking oxygen saturation, risk-stratification, and the role of pulse oximetry in primary care.

Pulse oximeters are essential for assessing blood oxygen levels in emergency departments, operating theatres, and hospital wards. However, although the role of pulse oximeters in detecting hypoxaemia and guiding oxygen therapy is widely recognised, their role in primary care settings is less clear. In this Viewpoint, we argue that pulse oximeters have a crucial role in risk-stratification in both hospital and primary care or outpatient settings. Our reanalysis of hospital and primary care data from diverse low-income and middle-income settings shows elevated risk of death for children with moderate hypoxaemia (ie, peripheral oxygen saturations [SpO

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Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests All authors have received institutional fellowship or grant funding related to pulse oximetry and oxygen research, including funding to conduct the original studies reanalysed in this Viewpoint: Save the Children UK (AGF, TC, CK, and HRG); Bill & Melinda Gates Foundation (AGF, TD, HRG, YK, EDM, AHB, SA, and TC); ELMA Philantrophies (YK); Swedish Research Council (HH, CK, and EDM); Einhorn Family Foundation (HH); Wellcome Trust (TC, CK, and EDM); National Institutes of Health (EDM and SH); WHO (TC, EDM, AHB, SA, and TC); United States Agency for International Development (EDM); US Centers for Disease Control and Prevention (EDM); Thrasher Research Fund (EDM); Moderna (EDM); National Health and Medical Research Council (HRG); and Royal Children's Hospital Foundation (HRG). YK is employed by Clinton Health Access Initiative, which contributes to global pulse oximetry and oxygen strategy. TC has received consulting fees from the UN and chairs a steering committee for an adolescent mental health trial in Nepal. HRG and EDM have served as advisers to the Tools for Integrated Management of Childhood Illness–Améliorer l'Identification des détresses Respiratoires chez l'Enfant (AIRE) pulse oximetry trial. EDM co-chairs the Union Child Pneumonia Working Group; HRG and CK co-chair the Lancet Global Health Commission on Medical Oxygen. AGF and HRG are board members for Oxygen for Life Initiative, a non-profit research and implementation group for pulse oximetry and oxygen. HRG, CK, and EDM have served as advisers to Lifebox Foundation, a non-governmental organisation that aims to increases access to pulse oximetry.