Clinical parameters that should be monitored include
temperature, respiratory rate, heart rate, oxygen saturation,
work of breathing (presence of retractions, nasal
flaring, grunting), and auscultatory findings.26 Hypoxic
infants and children may not appear cyanotic, and agitation
may be the only indication of hypoxia.26 Patients
whose oxygen saturation is less than 92 percent should be
treated with supplemental oxygen via nasal cannula, face
mask, or (in infants) an oxygen hood.26 No strong evidence
suggests that any of these methods is more effective
than another.33 Patients who receive supplemental
oxygen should have oxygen saturation levels evaluated
every four hours.26 Children in severe respiratory distress
should be evaluated for hypercapnia by arterial blood gas
measurements because oxygenation may be preserved.26
Children who are vomiting, have suboptimal oral intake,
or are severely ill require enteral or parenteral fluid therapy.
Chest physiotherapy has no effect on length of hospital
stay, duration of fever, or chest radiologic findings
in patients with pneumonia.