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Diagnosis
Tachypnea is a useful predictor of pneumonia in children with acute respiratory infection

https://doi.org/10.1136/ebm.5.5.152

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    (2000) Arch Dis Child 82, 41. Palafox M, Guiscafré H, Reyes H, et al.. Diagnostic value of tachypnoea in pneumonia defined radiologically.. Jan;. :. –5.
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 QUESTIONS: In children with acute respiratory infection, is tachypnea accurate for detecting pneumonia? Does disease duration, age of the child, or presence of malnutrition influence sensitivity and specificity?

    Design

    Blinded comparison of respiratory rate with findings on chest radiography.

    Setting

    A state referral hospital in Tlaxcala, Mexico.

    Participants

    110 children who were 3 days to 5 years of age (55% were ≥1 y of age) and had acute respiratory infection. Children who were clinically diagnosed with pneumonia were matched to control children with acute respiratory infection. 30% of children were underweight. Exclusion criteria were chronic diseases, genetic abnormalities, neurological diseases, bronchial asthma, or septicaemia.

    Description of test and diagnostic standard

    A paediatrician measured the respiratory rate by observing the child's chest movements for 1 minute while the child rested with no crying or fever. Tachypnea was defined as a respiratory rate >60 breaths/minute in children <2 months of age, >50 breaths/minute in children 2 to 12 months of age, and >40 breaths/minute in children ≥1 year of age. The diagnostic standard was chest radiography (not clinical diagnosis).

    Main outcome measures

    Sensitivity and specificity for detecting pneumonia.

    Main results

    59 children (54%) had a …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr H Martínez, Research Unit on Epidemiology and Health Services, Mexican Social Security Institute, Centro Médico Nacional Siglo XXI, Unidad de Congresos, Bloque B, 4o Piso, Avenida Cuauhtémoc 330, Col Doctores, Mexico 06725 DF. Fax +52 5 761 09 52.