• M H Gorelick, K N Shaw, K O Murphy, and M D Baker.
• Division of Emergency Medicine, Children's Hospital of Philadelphia, PA 19104-4399, USA.
• Pediatr Emerg Care. 1997 Oct 1; 13 (5): 305-7.

ObjectiveTo assess the effect of fever on capillary refill time in children.DesignProspective cohort study.SettingTertiary care children's hospital emergency department (ED).ParticipantsConvenience 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.InterventionNone.MeasurementsBefore 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.Main ResultsAmong 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.ConclusionsPresence of fever does not have a clinically important effect on capillary refill time in children.

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