Background: Bronchiolitis is the first episode of wheezing associated with low grade
fever, rhinitis, tachypnea, and increasing respiratory effort in a previously healthy
infant during the winter months, and it is the most common lower respiratory tract
infection in infancy.
Objectives: This study is designed to analyze the clinical signs and symptoms alone
or as combinations as possible predictors of severe hypoxemia in infants with
Patients and methods: This is a prospective study, which was carried out on 96
infants with a mean age of 7.74 ،ہ3.72 months who were admitted to Children
Welfare Teaching Hospital in Medical City-Baghdad with bronchiolitis during the
period from 1st
October 2006 to the 15th
March 2007. They are divided into two
groups: group one 46 cases (oxygen saturation (SaO2<90) and group two, 50 cases
(SaO2،ف90).Complete history taken from care taker and full examination done for each
patient. A portable oximeter was used to measure oxygen saturation.
Results: Forty nine (51%) of patients were males and 47 were females (49%), with
male to female ratio of 1.04:1. The mean age was (7.745،ہ3.7) months. The mean
oxygen saturation was (90%), with a median of (84.7%) and a range of (76%-89%) in
group one (SaO2<90), while it was (95.32%) with a range of (90%-99%) in group two
Conclusions: Reduced ability to feed, sleep disturbances, hypotonia and clinical
signs as suprasternal retractions, continuous nasal flaring, tachypnea, grunting, head
nodding and cyanosis appeared to be statistically highly significant in this study as
predictors of severe hypoxemia. Combinations of signs and symptoms that showed
statistically significant association with severe hypoxemia were: grunting or head
nodding, cyanosis or head nodding, tachypnea or sleep disturbance, tachypnea or
suprasternal retractions, and tachypnea or head nodding (p.value <0.0001) for all
mentioned combinations, So we recommend to use these combinations of signs and
symptoms as significant predictors of severe hypoxemia especially when pulse
oximetry is not available.