Which of the following is the most sensitive indicator of intravascular volume depletion in an infant presented with acute rotavirus gastroenteritis?
High-Yield Explanation
Intravascular volume depletion in infants and young children commonly due to gastrointestinal diseases, pneumonia or meningitis. Impoant clinical features in estimating the degree of dehydration include, Capillary refill time Postural blood pressure Hea rate changes Dryness of the lips and mucous membranes Lack of tears Lack of external jugular venous filling when supine Sunken fontanelle in an infant Oliguria Altered mental status Among these, hea rate is the most sensitive measure of intravascular volume status. Capillary refill is the the most sensitive measure of adequate circulation. Blood pressure fluctuations are an insensitive indicator, because hypotension is a late finding in hypovolemia. Ref: Ford D.M. (2012). Chapter 23. Fluid, Electrolyte, & Acid-Base Disorders & Therapy. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.