Hypovolemia signs: Pediatrics

Pediatrics

Hypotension is a late finding in pediatric patients (children may maintain a normal blood pressure until 35% of blood volume is lost). Tachycardia is sensitive but not specific indicator. Prolonged capillary refill (> 2 seconds) , especially when combined with tachycardia, is more specific, although it may be difficult to measure. Cold skin and decreased urine output may be present. Weak pulses, mottling, cyanosis , and impaired consciousness may all precede hypotension. In fact, hypotension is an ominous sign in pediatric patients. 

Hypovolemia in Pediatrics: Signs

  • Tachycardia: sensitive but not specific. Resolution may help guide therapy
  • Delayed Capillary Refill: specific if > 2 seconds
  • Others: weak pulses, mottling, cyanosis, and impaired consciousness (may all precede hypotension), cold skin, decreased urine output
  • Hypotension: late finding. OMINOUS

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