2015, Number 6
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Rev Invest Clin 2015; 67 (6)
Altitude Above Sea Level and Body Mass Index as Determinants of Oxygen Saturation in Children: The SON@ Study
Gochicoa-Rangel L, Pérez-Padilla R, Rodríguez-Moreno L, Montero-Matamoros A, Ojeda-Luna N, Martínez-Carbajal G, Hernández-Raygoza R, Ruiz-Pedraza D, Fernández-Plata MR, Torre-Bouscoulet L
Language: English
References: 14
Page: 366-371
PDF size: 938.03 Kb.
ABSTRACT
Background: Altitude above sea level and body mass index are well-recognized determinants of oxygen saturation in adult
populations; however, the contribution of these factors to oxygen saturation in children is less clear.
Objective: To explore
the contribution of altitude above sea level and body mass index to oxygen saturation in children.
Methods: A multi-center,
cross-sectional study conducted in nine cities in Mexico. Parents signed informed consent forms and completed a health status
questionnaire. Height, weight, and pulse oximetry were recorded.
Results: We studied 2,200 subjects (52% girls) aged
8.7 3.0 years. Mean body mass index, z-body mass index, and oxygen saturation were 18.1 ± 3.6 kg·m
-2, 0.58 ± 1.3, and
95.5 ± 2.4%, respectively. By multiple regression analysis, altitude proved to be the main predictor of oxygen saturation, with
non-significant contributions of age, gender, and body mass index. According to quantile regression, the median estimate of
oxygen saturation was 98.7 minus 1.7% per km of altitude above sea level, and the oxygen saturation fifth percentile
97.4 minus 2.7% per km of altitude.
Conclusions: Altitude was the main determinant of oxygen saturation, which on average
decreased 1.7% per km of elevation from a percentage of 98.7 at sea level. In contrast with adults, this study in children found
no association between oxygen saturation and obesity or age.
REFERENCES
West JB, Schoene RB, Milledge JS. In: West JB (Ed.) High Altitude Medicine and Physiology, 4th Ed. London, UK: Hodder Arnold. 2007;2:27-38.
Pérez-Padilla R, Torre-Bouscoulet L, Muiño A, et al. Prevalence of oxygen desaturation and use of oxygen at home in adults at sea level and moderate altitude. Eur Respir J. 2006;27:594-9.
Menezes AM, Victora CG, Perez-Padilla R. The Platino project: methodology of a multicenter prevalence survey of chronic obstructive pulmonary disease in major Latin American cities. BMC Med Res Methodol. 2004;4:15.
Crecen Sobrepeso y Obesidad Infantil en México 1.1% al año. 2014. Available at: http://www.insp.mx/noticias/nutriciony- salud/1200-crecen-sobrepeso-y-obesidad-infantil-en-mexico- 11-al-ano.html.
Huicho L, Pawson IG, León-Velarde F, et al. Oxygen saturation and heart rate in healthy school children and adolescents living at high altitude. Am J Hum Biol. 2001;13:761-70.
Schult S, Canelo-Aybar C. Oxygen saturation in healthy children aged 5 to 16 years residing in Huayllay, Peru at 4340 m. High Alt Med Biol. 2011;12:89-92.
Subhi R, Smith K, Duke T. When should oxygen be given to children at high altitude? A systematic review to define altitudespecific hypoxaemia. Arch Dis Child. 2009;94:6-10.
Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann Intern Med. 1980;93:391-8.
Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Report of the Medical Research Council Working Party. Lancet. 1981;1:681-6.
Salud, S. d. Oxigenoterapia crónica ambulatoria en edad adulta y pediátrica en los tres niveles de atención. 2013. Available at: http://www.cenetec.salud.gob.mx/interior/gpc.html.
Weitz CA, Garruto RM. A comparative analysis of arterial oxygen saturation among Tibetans and Han born and raised at high altitude. High Alt Med Biol. 2007;8:13-26.
Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol. 1985;108:206-11.
Crapo RO, Jensen RL, Hegewald M, Tashkin DP. Arterial blood gas reference values for sea level and an altitude of 1,400 meters. Am J Respir Crit Care Med. 1999;160:1525-31.
Zavorsky GS, Hoffman SL. Pulmonary gas exchange in the morbidly obese. Obes Rev. 2008;9:326-39.