Oxygen saturation in adolescent high-altitude residents, implications for clinical decision-making

Abstract

In high-altitude cities such as El Alto (4150 meters above sea level), reference values established at sea level are still applied, which can lead to misdiagnosis, overestimation of respiratory pathologies and clinical decisions with direct repercussions on nursing care. A quantitative, descriptive and cross-sectional study was carried out in 94 adolescents living permanently in El Alto, selected under inclusion and exclusion criteria (absence of acute respiratory infection, anemia, lung disease, pregnancy and tobacco use). Oxygen saturation was measured by non-invasive digital pulse oximetry, after three minutes of rest and with three consecutive readings, registering the most stable value. 71 % were 14 years old; 60 % male, 40 % female. The saturations at rest were; 47 % between 91-95 %, 42 % between 86-90 %, 7% between 80-85 % and 2 % between 96-100 %. The average was 88.2 % in 14-year-olds, 91.3 % in 15-year-olds, and 95% in 16-17-year-olds. The heart rate was between 91-100 bpm in 21 % of cases, and only 2 % reported a respiratory history. Most of them had saturations between 88 and 95 %, values compatible with a physiological adaptation to chronic hypobaric hypoxia typical of extreme altitude. These evaluations show the need to have contextualized reference values for populations living at high altitudes, avoiding inappropriate clinical interpretations and optimizing care decision-making.