Thompson M, Harnden A, Perera R, Mayon-White R, Smith L, McLeod D, Mant D
Department of Primary Health Care, Oxford University, Oxford, UK.
Arch Dis Child. 2009 May;94(5):361-5. doi: 10.1136/adc.2008.145011. Epub 2008 Nov 19.
To describe the reference range for heart rate in children aged 3 months-10 years presenting to primary care with self-limiting infections.
Cross-sectional study of children presenting to primary care with suspected acute infection. Heart rate was measured using a pulse oximeter and axillary temperature using an electronic thermometer. Centile charts of heart rates expected at given temperatures for children with self-limiting infections were calculated.
Ten general practice surgeries and two out-of-hours centres in England.
1933 children presenting with suspected acute infections were recruited from in-hours general practice surgeries (1050 or 54.3%) or out-of-hours centres (883 or 45.7%). After excluding children who subsequently attended hospital and those without a final diagnosis of acute infection, 1589 children were used to create the centile charts of whom (859 or 54.1%) had upper respiratory tract infections and (215 or 13.5%) non-specific viral illness.
Median, 75th, 90th and 97th centiles of heart rate at each temperature level.
Heart rate increased by 9.9-14.1 bpm with each 1 degrees C increment in temperature. The 50th, 75th, 90th and 97th centiles of heart rate at each temperature level are presented graphically.
Age-specific centile charts of heart rates expected at different temperatures should be used by clinicians in the initial assessment of children with acute infections. The charts will identify children who have a heart rate higher than expected for a given temperature and facilitate the interpretation of changes in heart rate on reassessment. Further research on the predictive value of the centile charts is needed to optimise their diagnostic utility.
描述因自限性感染就诊于基层医疗的3个月至10岁儿童的心率参考范围。
对因疑似急性感染就诊于基层医疗的儿童进行横断面研究。使用脉搏血氧仪测量心率，使用电子温度计测量腋温。计算自限性感染儿童在特定温度下预期心率的百分位数图表。
英国的10家全科诊所和2个非工作时间中心。
从工作时间的全科诊所（1050名或54.3%）或非工作时间中心（883名或45.7%）招募了1933名疑似急性感染的儿童。在排除随后住院的儿童和最终诊断不是急性感染的儿童后，1589名儿童被用于创建百分位数图表，其中859名（54.1%）患有上呼吸道感染，215名（13.5%）患有非特异性病毒疾病。
每个温度水平下心率的中位数、第75、90和97百分位数。
温度每升高1摄氏度，心率增加9.9 - 14.1次/分钟。以图表形式呈现了每个温度水平下心率的第50、75、90和97百分位数。
临床医生在对急性感染儿童进行初始评估时，应使用不同温度下预期心率的年龄特异性百分位数图表。这些图表将识别出心率高于给定温度预期值的儿童，并有助于在重新评估时解释心率变化。需要对百分位数图表的预测价值进行进一步研究，以优化其诊断效用。
