Gorelick M H, Shaw K N, Murphy K O, Baker M D
Division of Emergency Medicine, Children's Hospital of Philadelphia, PA 19104-4399, USA.
Pediatr Emerg Care. 1997 Oct;13(5):305-7. doi: 10.1097/00006565-199710000-00001.
To assess the effect of fever on capillary refill time in children.
Prospective cohort study.
Tertiary care children's hospital emergency department (ED).
Convenience sample of 234 children age one month to five years presenting to the ED with a complaint of vomiting, diarrhea, or poor oral fluid intake.
None.
Before any therapy, capillary refill was measured according to a standard protocol. Rectal temperature was measured in children less than three years old, oral temperature in older children. Fluid deficit was calculated as the percentage difference between initial weight and stable weight following treatment.
Among the 80 children with dehydration, defined as a deficit of > or = 5% of body weight, mean capillary refill was 2.0 +/- 1.0 seconds, versus 1.3 +/- 0.5 seconds in the well hydrated group (P < 0.001). Within each group, mean capillary refill time for febrile patients (temperature > or = 38.3 degrees C) was essentially the same as in those without fever. Using a two-second upper limit of normal, prolonged capillary refill had a sensitivity of 0.44 and specificity of 0.94 for diagnosing dehydration; the diagnostic performance did not differ when stratified by presence or absence of fever.
Presence of fever does not have a clinically important effect on capillary refill time in children.
评估发热对儿童毛细血管再充盈时间的影响。
前瞻性队列研究。
三级护理儿童医院急诊科。
便利抽样选取234名年龄在1个月至5岁之间因呕吐、腹泻或口服液体摄入不足而就诊于急诊科的儿童。
无。
在进行任何治疗前，按照标准方案测量毛细血管再充盈情况。对3岁以下儿童测量直肠温度，对年龄较大儿童测量口腔温度。计算液体缺失量，即初始体重与治疗后稳定体重之间的百分比差异。
在80名被定义为体重缺失≥5%的脱水儿童中，平均毛细血管再充盈时间为2.0±1.0秒，而在水分充足组中为1.3±0.5秒（P<0.001）。在每组中，发热患者（体温≥38.3℃）的平均毛细血管再充盈时间与无发热患者基本相同。以正常上限两秒为标准，延长的毛细血管再充盈对诊断脱水的敏感性为0.44，特异性为0.94；按有无发热分层时，诊断性能无差异。
发热对儿童毛细血管再充盈时间无临床重要影响。
