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. 2022 May 4:10:841628.
doi: 10.3389/fped.2022.841628. eCollection 2022.

Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country

Shamsun Nahar Shaima  1 , Tahmina Alam  1 , Abu Sadat Mohammad Sayeem Bin Shahid  1 , Lubaba Shahrin  1 , Monira Sarmin  1 , Farzana Afroze  1 , Irin Parvin  1 , Sharika Nuzhat  1 , Yasmin Jahan  1 , Gazi Md Salahuddin Mamun  1 , Haimanti Saha  1 , Mst Mahmuda Ackhter  1 , Md Zahidul Islam  1 , K M Shahunja  2 , Sufia Islam  3 , Tahmeed Ahmed  1   4 , Mohammod Jobayer Chisti  1
Affiliations

Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country

Shamsun Nahar Shaima et al. Front Pediatr. .

Abstract

Background: Pneumonia has been the leading infectious cause of morbidity and mortality in children under 5 years of age for the last several decades. Although most of these deaths occur due to respiratory failure, published data are limited regarding predicting factors and outcomes of respiratory failure in children hospitalized with pneumonia or severe pneumonia.

Objective: This study aimed to explore the prevalence, predicting factors, and outcomes of respiratory failure in children under-five with pneumonia or severe pneumonia.

Methods: In this retrospective chart analysis, we enrolled children under 5 years of age hospitalized with pneumonia or severe pneumonia in the Dhaka Hospital of International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) between August 2013 and December 2017. Comparisons were made between children with respiratory failure (n = 212) and those without respiratory failure (n = 4,412). Respiratory failure was defined when the oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) was <315.

Results: A total of 4,625 children with pneumonia or severe pneumonia were admitted during this study period. Among them, 212 (4.6%) children developed respiratory failure and formed the case group. A total of 4,412 (95.3%) children did not develop respiratory failure and formed the comparison group. In logistic regression analysis, after adjusting with potential confounders, severe sepsis [adjusted odds ratio (aOR): 12.68, 95% CI: 8.74-18.40], convulsion (aOR: 4.52, 95% CI: 3.06-6.68), anemia (aOR: 1.76, 95% CI: 1.20-2.57), and severe underweight (aOR: 1.97, 95% CI: 1.34-2.89) were found to be independently associated with respiratory failure. As expected, children with respiratory failure more often had fatal outcome than without respiratory failure (74, 1%, p < 0.001).

Conclusion: The results of our analyses revealed that prevalence of respiratory failure was 4.6% among under-five children hospitalized for pneumonia or severe pneumonia. Severe sepsis, convulsion, anemia, and severe underweight were the independent predictors for respiratory failure in such children and their case-fatality rate was significantly higher than those without respiratory failure. Early recognition of these predicting factors of respiratory failure may help clinicians imitating prompt treatment that may further help to reduce deaths in such children, especially in resource-limited settings.

Keywords: Bangladesh; children; outcome; pneumonia; respiratory failure.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study profile of the under-five children admitted with pneumonia or severe pneumonia with and without respiratory failure.
FIGURE 2
FIGURE 2
Seasonality of respiratory failure among under-five children over the study period.
See this image and copyright information in PMC

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