Authors’ conclusions: the existing referenceranges for heart rate and respiratory rate in children are inconsistent, and do not agree with centile charts derived from a systematic review of observational studies. This finding has potentially wide-ranging implications for clinical assessment of children, and for design of resuscitation guidelines, triage scores, and early warning systems.
Reviewers' commentary: the measure of cardiac and respiratory rate offers relevant information in children care decision making. This systematic review of quality concludes that the more used charts don’t agree in some values, carrying the risk of over or infra diagnosis of potential serious conditions. This study is based on multiple registers with heterogeneity of the population as well as of the registration process, what makes risky the extrapolation of the results. It seems important that big population studies were addressed in healthy children as well as in children with conditions such as fever or infections. In the meanwhile the clinician has to make decisions taking into account the existent variability and other examination data.