{"id":"https://openalex.org/W7203984465","doi":"https://doi.org/10.2147/imcrj.s628455","title":"Recognizing Cyanotic Congenital Heart Disease Masked by Infant Pneumonia in a Resource-Limited Setting: A Somali Case Report of Tetralogy of Fallot","display_name":"Recognizing Cyanotic Congenital Heart Disease Masked by Infant Pneumonia in a Resource-Limited Setting: A Somali Case Report of Tetralogy of Fallot","publication_year":2026,"publication_date":"2026-08-01","ids":{"openalex":"https://openalex.org/W7203984465","doi":"https://doi.org/10.2147/imcrj.s628455","pmid":"https://pubmed.ncbi.nlm.nih.gov/42666619","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13522739"},"language":"en","primary_location":{"id":"doi:10.2147/imcrj.s628455","doi":"https://doi.org/10.2147/imcrj.s628455","is_oa":true,"landing_page_url":"https://doi.org/10.2147/imcrj.s628455","pdf_url":"https://www.dovepress.com/article/download/118626","source":{"id":"https://openalex.org/S2738884135","display_name":"International Medical Case Reports Journal","issn_l":"1179-142X","issn":["1179-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","ki-jl-1","medline","norway-1","poland-40","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Medical Case Reports Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.dovepress.com/article/download/118626","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5147864603","display_name":"Abdillahi Bile Abdi","orcid":"https://orcid.org/0009-0007-4683-582X","observed_orcids":["https://orcid.org/0009-0007-4683-582X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Abdillahi Bile Abdi","raw_affiliation_strings":["Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia"],"raw_orcid":"https://orcid.org/0009-0007-4683-582X","affiliations":[{"raw_affiliation_string":"Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089257853","display_name":"Ahmed Moumin Abdilahi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ahmed Moumin Abdilahi","raw_affiliation_strings":["Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050896083","display_name":"Mohamoud Hashi Abdi","orcid":"https://orcid.org/0009-0009-4920-2846","observed_orcids":["https://orcid.org/0009-0009-4920-2846"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mohamoud Hashi Abdi","raw_affiliation_strings":["Borama Diagnostic Center, Borama, Somalia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Borama Diagnostic Center, Borama, Somalia","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147874731","display_name":"Mustafe Abdilahi Khairdon","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mustafe Abdilahi Khairdon","raw_affiliation_strings":["Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Medicine and Health Sciences, Adal Medical University, Borama, Somalia","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5106695859","display_name":"Abdirahman Omer Ali","orcid":"https://orcid.org/0009-0000-7206-8758","observed_orcids":["https://orcid.org/0009-0000-7206-8758"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Abdirahman Omer Ali","raw_affiliation_strings":["Research and Publication Office, Somaliland Medical Association, Borama, Somalia"],"raw_orcid":"https://orcid.org/0009-0000-7206-8758","affiliations":[{"raw_affiliation_string":"Research and Publication Office, Somaliland Medical Association, Borama, Somalia","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5106695859"],"corresponding_institution_ids":[],"apc_list":{"value":2320,"currency":"USD","value_usd":2320},"apc_paid":{"value":2320,"currency":"USD","value_usd":2320},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"Volume 19","issue":null,"first_page":"1","last_page":"9"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10300","display_name":"Congenital Heart Disease Studies","score":0.9901999831199646,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10300","display_name":"Congenital Heart Disease Studies","score":0.9901999831199646,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11579","display_name":"Cardiovascular and Diving-Related Complications","score":0.0013000000035390258,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12272","display_name":"Cardiovascular Conditions and Treatments","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/tetralogy-of-fallot","display_name":"tetralogy of Fallot","score":0.972000002861023},{"id":"https://openalex.org/keywords/cyanotic-congenital-heart-disease","display_name":"cyanotic congenital heart disease","score":0.9959999918937683},{"id":"https://openalex.org/keywords/community-acquired-pneumonia","display_name":"community-acquired pneumonia","score":0.9279999732971191},{"id":"https://openalex.org/keywords/oxygen-desaturation","display_name":"oxygen desaturation","score":0.7710000276565552},{"id":"https://openalex.org/keywords/resource-limited-settings","display_name":"resource-limited settings","score":0.6779999732971191},{"id":"https://openalex.org/keywords/infants","display_name":"infants","score":0.32199999690055847},{"id":"https://openalex.org/keywords/propranolol","display_name":"propranolol","score":0.7289999723434448},{"id":"https://openalex.org/keywords/low-flow-nasal-cannula","display_name":"low-flow nasal cannula","score":0.6499999761581421},{"id":"https://openalex.org/keywords/echocardiography","display_name":"echocardiography","score":0.6179999709129333},{"id":"https://openalex.org/keywords/failure-to-thrive","display_name":"failure to thrive","score":0.5860000252723694},{"id":"https://openalex.org/keywords/right-ventricular-outflow-tract-obstruction","display_name":"right ventricular outflow tract obstruction","score":0.6970000267028809}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9605000019073486},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.6187999844551086},{"id":"https://openalex.org/C2777361368","wikidata":"https://www.wikidata.org/wiki/Q7920318","display_name":"Ventricular outflow tract","level":2,"score":0.6064000129699707},{"id":"https://openalex.org/C2778646171","wikidata":"https://www.wikidata.org/wiki/Q445307","display_name":"Tetralogy of Fallot","level":3,"score":0.579200029373169},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5498999953269958},{"id":"https://openalex.org/C2776917539","wikidata":"https://www.wikidata.org/wiki/Q1497481","display_name":"Failure to thrive","level":2,"score":0.4381999969482422},{"id":"https://openalex.org/C2778921608","wikidata":"https://www.wikidata.org/wiki/Q2002035","display_name":"Ventricle","level":2,"score":0.42010000348091125},{"id":"https://openalex.org/C2777914695","wikidata":"https://www.wikidata.org/wiki/Q12192","display_name":"Pneumonia","level":2,"score":0.4196000099182129},{"id":"https://openalex.org/C2780074459","wikidata":"https://www.wikidata.org/wiki/Q389735","display_name":"Heart disease","level":2,"score":0.4189000129699707},{"id":"https://openalex.org/C2778297461","wikidata":"https://www.wikidata.org/wiki/Q2090736","display_name":"Pulmonary atresia","level":3,"score":0.4092999994754791},{"id":"https://openalex.org/C2778198053","wikidata":"https://www.wikidata.org/wiki/Q181754","display_name":"Heart failure","level":2,"score":0.40230000019073486},{"id":"https://openalex.org/C80093799","wikidata":"https://www.wikidata.org/wiki/Q366155","display_name":"Intracardiac injection","level":2,"score":0.38600000739097595},{"id":"https://openalex.org/C2779384505","wikidata":"https://www.wikidata.org/wiki/Q17007513","display_name":"Concomitant","level":2,"score":0.3431999981403351},{"id":"https://openalex.org/C2776779939","wikidata":"https://www.wikidata.org/wiki/Q1479485","display_name":"Hypoxemia","level":2,"score":0.3361000120639801},{"id":"https://openalex.org/C2777385415","wikidata":"https://www.wikidata.org/wiki/Q1615191","display_name":"Cardiac catheterization","level":2,"score":0.31439998745918274},{"id":"https://openalex.org/C2779295919","wikidata":"https://www.wikidata.org/wiki/Q4677930","display_name":"Acute decompensated heart failure","level":3,"score":0.31290000677108765},{"id":"https://openalex.org/C2780334268","wikidata":"https://www.wikidata.org/wiki/Q3435476","display_name":"Nasal cannula","level":3,"score":0.29829999804496765},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.29269999265670776},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.29100000858306885},{"id":"https://openalex.org/C2776548574","wikidata":"https://www.wikidata.org/wiki/Q486485","display_name":"Anasarca","level":2,"score":0.2888000011444092},{"id":"https://openalex.org/C2780631030","wikidata":"https://www.wikidata.org/wiki/Q579527","display_name":"Pulmonary valve stenosis","level":3,"score":0.2854999899864197},{"id":"https://openalex.org/C2779376020","wikidata":"https://www.wikidata.org/wiki/Q2014808","display_name":"Right ventricular hypertrophy","level":3,"score":0.2734000086784363},{"id":"https://openalex.org/C2777935831","wikidata":"https://www.wikidata.org/wiki/Q3144949","display_name":"Hemopericardium","level":3,"score":0.2628999948501587},{"id":"https://openalex.org/C2776888751","wikidata":"https://www.wikidata.org/wiki/Q767485","display_name":"Respiratory failure","level":2,"score":0.257999986410141},{"id":"https://openalex.org/C2993183539","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory infection","level":3,"score":0.2531999945640564},{"id":"https://openalex.org/C2780930700","wikidata":"https://www.wikidata.org/wiki/Q1128595","display_name":"Pulmonary hypertension","level":2,"score":0.2526000142097473}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.2147/imcrj.s628455","doi":"https://doi.org/10.2147/imcrj.s628455","is_oa":true,"landing_page_url":"https://doi.org/10.2147/imcrj.s628455","pdf_url":"https://www.dovepress.com/article/download/118626","source":{"id":"https://openalex.org/S2738884135","display_name":"International Medical Case Reports Journal","issn_l":"1179-142X","issn":["1179-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","ki-jl-1","medline","norway-1","poland-40","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Medical Case Reports Journal","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13522739","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13522739/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13522739/pdf/IMCRJ-19-628455.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Int Med Case Rep J","raw_type":"Text"},{"id":"pmid:42666619","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42666619","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International medical case reports journal","raw_type":"Case Reports"},{"id":"pmh:oai:dovepress.com/118626","doi":null,"is_oa":true,"landing_page_url":"https://www.dovepress.com/recognizing-cyanotic-congenital-heart-disease-masked-by-infant-pneumon-peer-reviewed-fulltext-article-IMCRJ","pdf_url":null,"source":{"id":"https://openalex.org/S4306401012","display_name":"Dove Medical Press (Taylor and Francis Group)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"info:eu-repo/semantics/article"}],"best_oa_location":{"id":"doi:10.2147/imcrj.s628455","doi":"https://doi.org/10.2147/imcrj.s628455","is_oa":true,"landing_page_url":"https://doi.org/10.2147/imcrj.s628455","pdf_url":"https://www.dovepress.com/article/download/118626","source":{"id":"https://openalex.org/S2738884135","display_name":"International Medical Case Reports Journal","issn_l":"1179-142X","issn":["1179-142X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","ki-jl-1","medline","norway-1","poland-40","russia-white-list-3"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Medical Case Reports Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203984465.pdf","grobid_xml":"https://content.openalex.org/works/W7203984465.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W2008326796","https://openalex.org/W2014349280","https://openalex.org/W2079080288","https://openalex.org/W2084775350","https://openalex.org/W2407986068","https://openalex.org/W2574228127","https://openalex.org/W3029562873","https://openalex.org/W3109131815","https://openalex.org/W4281564116","https://openalex.org/W4379472682","https://openalex.org/W4400736428","https://openalex.org/W4406527991","https://openalex.org/W4406724494","https://openalex.org/W4408679820","https://openalex.org/W4411673484","https://openalex.org/W4412018926","https://openalex.org/W4413436040","https://openalex.org/W4413814670","https://openalex.org/W4414444342","https://openalex.org/W7131629586"],"related_works":["https://openalex.org/W7219264971","https://openalex.org/W2031180970","https://openalex.org/W6987431258","https://openalex.org/W4283215597","https://openalex.org/W7125708821","https://openalex.org/W2809240642","https://openalex.org/W3207866209","https://openalex.org/W7162226110","https://openalex.org/W2056488308","https://openalex.org/W4307125626"],"abstract_inverted_index":{"Background:":[0],"In":[1],"resource-limited":[2,297],"settings":[3],"lacking":[4],"routine":[5],"newborn":[6],"screening,":[7],"common":[8,37],"lower":[9],"respiratory":[10,68,252],"tract":[11,185],"infections":[12,253],"like":[13],"community-acquired":[14],"pneumonia":[15,316],"(CAP)":[16],"can":[17,254],"obscure":[18,259],"or":[19,307,339],"delay":[20],"the":[21,35,217,226,312],"diagnosis":[22,80],"of":[23,31,81,90,137,191,220,314],"underlying":[24,267,293],"cyanotic":[25,38],"congenital":[26],"heart":[27,92,269],"disease":[28],"(CHD).":[29],"Tetralogy":[30],"Fallot":[32],"(TOF)":[33],"is":[34],"most":[36],"CHD,":[39],"yet":[40],"its":[41],"co-occurrence":[42],"with":[43,66,168,187,199,244,266],"CAP":[44],"creates":[45],"significant":[46],"diagnostic":[47,288],"masking,":[48],"as":[49,274,319],"acute":[50,138,315],"pulmonary":[51,211],"signs":[52,89,263],"often":[53],"conceal":[54],"cardiac":[55,247,261,294],"abnormalities.":[56],"Case":[57],"Presentation:":[58],"A":[59],"5-month-old":[60],"male":[61],"presented":[62],"in":[63,224,264,296],"Borama,":[64],"Somalia,":[65,225],"severe":[67,82,130,180,195],"distress,":[69],"fever,":[70],"cough,":[71],"and":[72,107,119,135,140,157,194,210,235,242,258,283,336],"bilateral":[73],"crackles,":[74,142],"leading":[75],"to":[76,96,153,291],"an":[77,292],"initial":[78],"clinical":[79,124],"CAP.":[83],"Detailed":[84],"history":[85],"revealed":[86],"unrecognized":[87],"pre-existing":[88],"structural":[91,268],"disease,":[93],"including":[94],"failure":[95],"thrive":[97],"(Moderate":[98],"Acute":[99,251],"Malnutrition,":[100],"weight":[101,281,305],"4.6":[102],"kg,":[103],"z-score":[104],"<":[105],"2)":[106],"feeding":[108,159,302],"diaphoresis.":[109],"Although":[110],"cardiovascular":[111,331],"examination":[112],"on":[113,129,149,230],"admission":[114],"demonstrated":[115,165],"a":[116,120,188,200],"precordial":[117],"thrill":[118],"harsh":[121],"systolic":[122],"murmur,":[123],"management":[125],"was":[126,228],"initially":[127],"anchored":[128],"pneumonia.":[131],"Following":[132],"antibiotic":[133],"escalation":[134],"resolution":[136,313],"fever":[139],"lung":[141],"persistent":[143,284],"resting":[144],"oxygen":[145,239],"desaturation":[146,310],"(SpO2":[147],"88%":[148],"room":[150],"air,":[151],"dropping":[152],"78-82%":[154],"during":[155,278],"crying)":[156],"unmasked":[158],"diaphoresis":[160],"prompted":[161],"echocardiography.":[162],"Transthoracic":[163],"echocardiography":[164,338],"features":[166],"consistent":[167],"TOF":[169],"(large":[170],"8.5":[171],"mm":[172,203],"perimembranous":[173],"ventricular":[174,183,197],"septal":[175,205],"defect,":[176],"45-50%":[177],"overriding":[178],"aorta,":[179],"infundibular/valvular":[181],"right":[182,196,208],"outflow":[184],"obstruction":[186],"peak":[189],"gradient":[190],"67.2":[192],"mmHg,":[193],"hypertrophy)":[198],"concomitant":[201],"4.2":[202],"atrial":[204],"defect.":[206],"Double-outlet":[207],"ventricle":[209],"atresia":[212],"were":[213],"ruled":[214],"out.":[215],"Given":[216],"total":[218],"lack":[219],"open-heart":[221],"surgical":[222,248,341],"infrastructure":[223],"patient":[227],"stabilized":[229],"oral":[231],"propranolol":[232],"(1":[233],"mg/kg/day)":[234],"low-flow":[236],"nasal":[237],"cannula":[238],"(1.5-2":[240],"L/min)":[241],"registered":[243],"international":[245],"humanitarian":[246],"networks.":[249],"Discussion:":[250],"precipitate":[255],"physiological":[256],"stress":[257],"classic":[260],"physical":[262],"infants":[265],"defects.":[270],"Subtle":[271],"red":[272,320],"flags-such":[273],"feeding-induced":[275],"sweating,":[276],"fatigue":[277],"feeds,":[279],"poor":[280,304],"gain,":[282,306],"post-pneumonia":[285],"cyanosis-are":[286],"critical":[287],"clues":[289],"pointing":[290],"lesion":[295],"environments.":[298],"Conclusion:":[299],"Persistent":[300],"cyanosis,":[301],"diaphoresis,":[303],"unexplained":[308],"arterial":[309],"following":[311],"must":[317],"serve":[318],"flags":[321],"for":[322],"frontline":[323],"clinicians.":[324],"These":[325],"findings":[326],"should":[327],"immediately":[328],"prompt":[329],"structured":[330],"re-evaluation,":[332],"pulse":[333],"oximetry":[334],"reassessment,":[335],"urgent":[337],"pediatric":[340],"referral.":[342]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-08-23T00:00:00"}
