Orthostatic Hypotension in Children with Acute Febrile Illness

The Journal of Emergency Medicine, 05/16/2012

Shalem T et al. – The incidence of orthostatic hypotension among febrile children in the Pediatric Emergency Department (PED) is high, and may explain common symptoms such as dizziness or syncope. Such patients should be instructed to drink properly and to avoid rapid changes in body posture.

Methods

  • A prospective cohort study was conducted at the PED at Assaf Harofeh Medical Center, a university-affiliated hospital in Israel.
  • Eighty children aged 4–18years were recruited.
  • Thirty-nine had fever (>38°C for 6–48h) and 41 were afebrile.
  • All subjects had their blood pressure measured in the supine position (after 5min of rest) and again after standing for 3min.
  • The main outcome measure was orthostatic hypotension, that is, a reduction of systolic blood pressure of at least 20mm Hg, or a fall in diastolic blood pressure of at least 10mm Hg within 3min of standing.

Results

  • There were no differences between the groups in gender, age, height, or weight.
  • Orthostatic hypotension was found in 10/39 (25.6%) of febrile children and in 2/41 (5%) of afebrile children (p=0.012).

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