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Table 2 Ability of clinical signs to identify hypovolaemia in adults with severe malaria

From: The reliability of the physical examination to guide fluid therapy in adults with severe falciparum malaria: an observational study

Clinical finding Hypovolaemic1 Euvolaemic1 PPV NPV Sensitivity Specificity
    (95% CI) (95% CI) (95% CI) (95% CI)
Dry mucous membranes 235/324 42/65 85% 21% 73% 35%
(80–89) (14–29) (68–78) (24–48)
Dry axillae 138/324 27/65 84% 17% 43% 58%
(77–89) (12–23) (37–48) (46–71)
Decreased tissue turgor 12/324 7/65 63% 16% 4% 89%
(38–84) (12–20) (2–6) (79–96)
Prolonged capillary refill 2,3 28/307 1/53 97% 16% 9% 98%
(82–100) (12–20) (6–13) (90–100)
Tachycardia > 100 bpm3 127/308 16/53 89% 17% 41% 70%
(82–93) (12–23) (36–47) (56–82)
Tachycardia > 120 bpm3 28/308 2/53 93% 15% 9% 96%
(78–99) (12–20) (6–13) (87–100)
Low JVP4 101/303 18/64 85% 18% 33% 72%
(77–91) (14–24) (28–39) (59–82)
  1. PPV Positive predictive value, NPV Negative predictive value.
  2. 1 Hypovolaemic: global end diastolic volume index (GEDVI) <680 ml/m2, euvolaemic: GEDVI: 680–800 ml/m2.
  3. 2 Greater than 2 seconds.
  4. 3 Excluding patients receiving inotropic support.
  5. 4 JVP < 3-4 cm above the sternal angle with the patient at 45º.