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

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

Clinical finding Pulmonary oedema* No pulmonary oedema PPV NPV Sensitivity Specificity
(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 JVP1# 47/92 121/247 28% (21–35) 74% (66–80) 51% (40–62) 51% (45–57)
Low JVP2# 31/92 69/247 31% (22–41) 74% (68–80) 34% (24–44) 72% (66–78)
  1. PPV Positive predictive value, NPV Negative predictive value.
  2. * Extravascular lung water index ≥ 11 ml/kg (patients with concomitant aspiration pneumonia excluded).
  3. 1 JVP ≥5 cm above the sternal angle with the patient at 45º.
  4. 2 JVP < 3–4 cm above the sternal angle with the patient at 45º.
  5. # JVP not visible in all patients.