This article is more than 5 years old. Information may no longer be current.
Clinical dehydration scale alone not reliable; additional evaluation needed
Click Here to Manage Email Alerts
A dehydration scale should not be the only measure of dehydration in pediatric patients because these results may be unreliable for younger patients, according to researchers.
Laura M. Kinlin, BSc, MPH, and colleagues of Dalhousie University in Halifax, Nova Scotia, Canada, and The Hospital for Sick Children in Toronto looked at 226 children aged older than 3 months who were admitted to The Hospital for Sick Children’s ED and required IV rehydration. To qualify for the study, children needed an acute gastroenteritis diagnosis, evidence of dehydration and a decision to administer rehydration therapy, according to the study findings.
Kinlin and colleagues used Friedman’s clinical dehydration scale (CDS), whose scores range from 0 to 8, with higher scores indicating more moderate/severe levels. Dehydration was defined based on the presence of one of the following: CDS score of at least 3; capillary refill time of 2 seconds or longer; abnormal skin turgor with prolonged retraction time and “tenting”; and/or abnormal respiratory pattern, defined as more than 50 breaths per minute for children aged younger than 12 months and more than 40 breaths per minute for children aged at least 12 months.
The researchers concluded that although the scale can help assess dehydration, it was not reliable enough to be used alone because interobserver reliability was moderate and there was no correlation between CDS score and percent weight gain.
“The CDS exhibited moderate interobserver reliability and limited criterion, construct, and discriminatory validity,” the researchers wrote. “Although previous research has found that it can differentiate children with none/some and moderate/severe dehydration, our data do not support its use in isolation to make treatment determinations (ie, need for intravenous rehydration) among children with evidence of dehydration.”
Disclosure: Ms. Kinlin reports no relevant financial disclosures.
Collapse
Kinlin LM. Pediatrics. 2012;129:1211-1219.
Click Here to Manage Email Alerts