[Use of laser Doppler to assess peripheral tissue perfusion in critically ill children]. / Evaluación de la perfusión tisular periférica mediante láser Doppler en niños en estado crítico.

ABSTRACT

OBJECTIVE: To analyze skin tissue perfusion at different sites in critically ill children. PATIENTS AND METHODS: A prospective observational study was performed on 41 critically ill children with a median age of 12 months and weight of 8.2 kg. Skin tissue flow was measured in each patient using laser Doppler consecutively in the foot, forearm, thigh and hypochondrium, and its association with demographic and hemodynamic variables, as well as lactate and inotropic index, was analyzed. RESULTS: A total of 144 tissue flow measurements were made, with a median flow of 3.2±2.2 ml/min/100 g tissue. There was a moderate correlation between the tissue flow measured in central locations, abdomen-arm (r(2) 0.574, P=.001), abdomen-thigh (r(2) 0.423, P=.002) and thigh-arm (r(2) 0.703, P<.000), but not with the peripheral measurements (sole of the foot). The limits of agreement, measured between the different locations, were wide (range 6.1 to -2.5 ml/min/100g). There was a slight-moderate correlation between the flow in the sole of the foot with weight (-0.355, P=.039), age (-0.343, P=.044), peripheral temperature (0.503, P=.017) and inotropic index (-0.443, P=.008). CONCLUSIONS: Tissue flow in the foot correlates with weight, age, peripheral temperature and inotropic index. Further studies are needed to analyze its usefulness in assessing peripheral perfusion in situations of shock.