The reliability of the physical examination to guide fluid therapy in adults with severe falciparum malaria: an observational study

Table 5 Ability of clinical signs to identify pulmonary oedema in adults with severe malaria

Clinical finding	Pulmonary oedema*	No pulmonary oedema	PPV	NPV	Sensitivity	Specificity
Clinical finding	Pulmonary oedema*	No pulmonary oedema	(95% CI)	(95% CI)	(95% CI)	(95% CI)
Crepitations on auscultation	30/99	46/254	39% (28–51)	75% (70–80)	39% (21–40)	82% (77–86)
Tachypnoea >20 breaths/min	81/98	221/250	27% (22–32)	63% (48–77)	83% (74–90)	12% (8–16)
Tachypnoea >30 breaths/min	38/98	71/250	35% (26–45)	75% (69–80)	39% (29–49)	72% (66–77)
Elevated JVP^1#	47/92	121/247	28% (21–35)	74% (66–80)	51% (40–62)	51% (45–57)
Low JVP^2#	31/92	69/247	31% (22–41)	74% (68–80)	34% (24–44)	72% (66–78)

PPV Positive predictive value, NPV Negative predictive value.
* Extravascular lung water index ≥ 11 ml/kg (patients with concomitant aspiration pneumonia excluded).
¹ JVP ≥5 cm above the sternal angle with the patient at 45º.
² JVP < 3–4 cm above the sternal angle with the patient at 45º.
^# JVP not visible in all patients.

ISSN: 1475-2875