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Evidence summaries

Assessment of the Degree of Dehydration in Infants and Young Children

The most useful individual signs for predicting moderate or more severe dehydration in children (1 month to 5 years) appear to be an abnormal capillary refill time, abnormal skin turgor, and abnormal respiratory pattern. Level of evidence: "B"

A systematic review 1 included 13 studies with a total of 1144 subjects. The most useful individual signs for predicting 5% dehydration in children were an abnormal capillary refill time (LR, 4.1; 95% CI, 1.7-9.8), abnormal skin turgor (LR, 2.5; 95% CI, 1.5-4.2), and abnormal respiratory pattern (LR, 2.0; 95% CI, 1.5-2.7). Combinations of examination signs perform markedly better than any individual sign in predicting dehydration. None of the included studies was of high quality.

Comment: The quality of evidence is downgraded by limitations in study quality.

    References

    • Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? JAMA 2004 Jun 9;291(22):2746-54. [PubMed]

Primary/Secondary Keywords