Dehydration In Children Calculator

Evaluates the degree of dehydration in pediatric patients by using the Clinical Dehydration Scale (CDS).

There is in depth information about the original study and on how the clinical dehydration scale is interpreted below the tool.


The dehydration in children calculator is based on the Clinical Dehydration Scale (CDS) created by Friedman et al. in 2004.

It is aimed at assessing dehydration in infants between 1 and 36 months based on general appearance, eyes, tongue and tears.

Each of the 4 areas is assessed on a scale from normal to significant dehydration.


The study was conducted on a cohort of 137 children suffering from gastroenteritis (treated in the pediatric emergency department) with ages between 1 and 36 months (median age: 18 months).

■ Validity (assessed by Pearson's correlation coefficient): 0.36 to 0.57;

■ Reliability (assessed by the intra-class correlation coefficient): 0.77;

■ Discriminatory power (assessed by Ferguson's delta): 0.83.

Validation was conducted on a cohort of 205 children with acute gastroenteritis. The monitored outcomes were:

■ Length of stay;

■ Prescription of intravenous fluid;

■ Abnormal serum pH values or bicarbonate levels.


1

General appearance

2

Eyes

3

Mucous membranes (tongue)

4

Tears

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


Dehydration in children is most likely caused by insufficient water intake or as consequence of a symptom of a condition, like in the case of vomiting, diarrhea or fever.

The severity of it will depend on the amount and type of fluid loss and the age of the patient, in this case, infants and younger children have a higher propensity for dehydration, due to the smaller fluid reserve in their bodies or due to lack of cooperation at oral rehydration.

 

Clinical Dehydration Scale items

The following table introduces the 4 items in the dehydration in children calculator and their weight (in points) in the final score:

Item 0 points 1 point 2 points
General appearance Normal Thirsty, restless, or lethargic but irritable when touched Drowsy, limp, cold, sweaty
Eyes Normal Slightly sunken Very sunken
Mucous membranes (tongue) Moist Sticky Dry
Tears Present Decreased Absent

There are other clinical features that can be looked at when searching for signs of dehydration, such as: decreased radial pulse, decreased systolic blood pressure, skin elasticity, urinary flow or percentage of body weight loss.

The most common signs include: cracked lips and a dry mouth, drowsiness, fatigue, sunken eyes, lack of tears, cold, dry skin, urine output modifications.

 

Result interpretation

According to the clinical dehydration scale, the patients are placed in either of the three degrees of dehydration, dependent on the score obtained:

CDS result (points) Degree of dehydration Correlation with dehydration
0 None <3%
1 - 4 Some 3%–6%
5 - 8 Moderate to severe ≥6%

Therefore, a result of 5 points marks the threshold between some degree of dehydration and moderate to severe dehydration.

 

About the original study

The study was conducted on a cohort of 137 children suffering from gastroenteritis (treated in the pediatric emergency department) with ages between 1 and 36 months (median age: 18 months).

The score was performed on arrival and after rehydration was considered complete.

Some of the characteristics include:

■ Validity (assessed by Pearson's correlation coefficient): 0.36 to 0.57;

■ Reliability (assessed by the intra-class correlation coefficient): 0.77;

■ Discriminatory power (assessed by Ferguson's delta): 0.83.

The CDS was validated during a 4 month period at a pediatric emergency department on 205 patients with acute gastroenteritis presentation aged from 1 month to 5 years. The outcome measurements were:

■ Length of stay;

■ Prescription of intravenous fluid;

■ Abnormal serum pH values or bicarbonate levels.

The scale was found of reliable accuracy in predicting need for intravenous fluid rehydration and a longer hospitalization in pediatric patients with acute gastroenteritis.

Jeremy Friedman M B. ChB FRCPC, the creator of the CDS is Associate Chair, Clinical Programs at the Hospital for Sick Children, Toronto, Ontario, Canada and a paediatrics professor at the University of Toronto Faculty of Medicine. He is specialised in general, hospitalist and complex care paediatrics. Browse his research on PubMed.

 

Original reference

Friedman JN, Goldman RD, Srivastava R, Parkin PC. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr. 2004; 145(2):201-7.

Validation study

Goldman RD, Friedman JN, Parkin PC. Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics. 2008; 122(3):545-9.

Other reference

Chow CM, Leung AKC, Hon KL. Acute gastroenteritis: from guidelines to real life. Clin Exp Gastroenterol. 2010; 3: 97–112.


App Version: 1.0.1

Coded By: MDApp

Specialty: Pediatrics

Objective: Assessment

Type: Calculator

No. Of Items: 4

Year Of Study: 2004

Abbreviation: CDS

Article By: Denise Nedea

Published On: March 16, 2017 · 03:05 PM

Last Checked: March 16, 2017

Next Review: March 10, 2018