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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