Prediction of Shock by Peripheral Perfusion Index

To detect occurrence of clinical shock and impending shock by monitoring Peripheral Perfusion Index (PI).

In this study, 100 children aged 1 mo to 12 y of age who needed hemodynamic monitoring were included and categorized into five age groups. Demographic data, nutritional status, vital parameters, perfusion index and laboratory parameters were recorded. Hemodynamic monitoring was done for 48 h. In total, 65 and 35 children were admitted with and without features of shock respectively. Nine hundred thirty six hemodynamic measurements were taken and analyzed. Correlation between perfusion index, blood pressures and clinically assessed shock were done.

Clinical shock can be reasonably detected when perfusion index value is less than 1.15 in children less than 3 y of age, less than 1.25 in 3 to 10 y of age and less than 1.55 in 10 to 12 y of age. These values had high sensitivity and low false positivity in detecting clinically assessed shock in that particular age group. PI had good correlation with pulse pressure and systolic blood pressure in all age groups and weak correlation with mean arterial blood pressure and diastolic blood pressure. A 57% reduction in PI value from the baseline value may predict impending shock in children.

Perfusion index can be used as a non-invasive, continuous parameter to monitor peripheral perfusion in children and to detect impending shock.