A systematic review included 13 studies with a total of 1144 subjects. The most useful individual signs for predicting 5% dehydration in children were an abnormal capillary refill time (LR, 4.1; 95% CI, 1.7-9.8), abnormal skin turgor (LR, 2.5; 95% CI, 1.5-4.2), and abnormal respiratory pattern (LR, 2.0; 95% CI, 1.5-2.7). Combinations of examination signs perform markedly better than any individual sign in predicting dehydration. None of the included studies was of high quality.
Comment: The quality of evidence is downgraded by limitations in study quality.