Retrospective analysis of fever, pulse and respiratory parameters in children according to etiology

Objective: This study aimed to examine respiratory and heart rates in children with febrile illness who were followed up in our clinic between January 2020 and December 2022 and evaluate the relationship between them according to etiologic differences. Cases and Methods: Patients with upper respiratory tract infection, pneumonia, heart disease, neutropenic fever, MIS-C diagnosed with upper respiratory tract infection, pneumonia, heart disease, neutropenic fever, and fever at the time of hospitalization or during hospitalization at Ondokuz Mayıs University Pediatrics Hospital between January 2020 and December 2022, registered in the hospital information processing system, were included in the study. Those with significant anaemia were evaluated as a separate group among these patients. The information recorded in the design and patient files of the identified patients were retrospectively analyzed. Gender, age at admission, vital parameters (fever, respiratory rate, pulse rate, hemogram, C-reactive protein), duration of hospitalization and follow-up were determined from the records. IBM SPSS 22 program was used for statistical analyses. Analysis of variance, Shapiro Wilk test, Kruskal Wallis H test, Levene test, one-way ANOVA and Welch ANOVA test were used for statistical evaluations. Results: The mean age of 205 patients included in the study was 76.1561.08 (min=1, max=204) months. According to the diagnostic groups (URTI, pneumonia, heart disease, neutropenic fever, MIS-C, marked anaemia), the rate of respiratory rate deviation at the time of fever attack (S.S1) was significantly higher in the pneumonia group. Although there was an increase in pulse rate in all diagnostic groups at the time of the fever attack, there was no significant difference between the groups in the deviation in pulse rate (N.S1) values. In pneumonia and heart disease group, a significant increase in respiratory rate was detected at 3,6,15 and 18 hours of the fever-free period. In addition, the respiratory rate at 9,12 and 21 hours of the fever- free period was significantly higher in the pneumonia group. In the neutropenic fever group, the pulse rate at 12, 21, and 24 hours of the fever-free period was significantly higher. At the 21st hour of the fever-free period, the pulse rate was significantly higher in the neutropenic fever and marked anaemia groups. At the 3rd hour of the fever-free period, the V.S.S3 level was higher in the patients with heart disease compared to the MIS-C group. The CRP value at the time of the fever attack in the MIS-C group was found to be higher than in the other groups. CRP increase was found to be significantly higher in the heart disease and neutropenic fever group. Conclusion: It was observed that the increase in respiratory rate was higher in the pneumonia group in the fever attack and tachypnea continued in the fever-free period. For these reasons, if tachypnea in febrile patients is higher than expected and persists in the fever-free period, lower respiratory tract infections should be considered primarily. The pulse rate was found to be higher in the group with significant anaemia until erythrocyte transfusion. Erythrocyte transfusion should not be delayed in patients with marked anaemia to correct tissue hypoxia without delay and reduce cardiac load.