Comparing three methods of assessing peripheral perfusion in critically ill children.

BACKGROUND Evaluation of peripheral perfusion is a standard practice in pediatric intensive care units (PICUs), which includes the qualitative assessment of foot warmth. The perfusion indicator, derived from the pulse oximetry signal, is available, along with some bedside monitors. OBJECTIVES To describe the correlation between RN qualitative assessment of foot warmth, measured foot temperature, and perfusion indicator. METHODS Simultaneous measurements of qualitative foot warmth, measured foot temperature, and perfusion indicator value were obtained on 39 critically ill children ages newborn to 18 years, at least every 2 hours for 48 hours, with 859 measurements completed. RESULTS There was a positive correlation between all three parameters (p = < 0.0001); however, there was a large amount of variability within groups. CONCLUSION Qualitative assessment of foot warmth and peripheral perfusion indicator may be helpful in assessing the perfusion in critically ill pediatric patients, but neither is predictably specific as compared to measured foot temperature.