title: The big toe in the recovery room: peripheral warm-up patterns in children after open-heart surgery.
abstract: To evaluate the usefulness of toe temperature warm-up patterns in predicting survival in a group of pediatric patients after cardiac surgery, the condition of 70 children [age 3.9 years + / - 3.8 yr] was evaluated for 24 hours postoperatively by direct and indirect cardiac monitoring, including toe temperature, while in a heat controlled environment. Two groups were identified 60 survivors and 10 nonsurvivors. The volume balance, pH and urine output of all patients were maintained within acceptable values, but nonsurvivors had a persistently lower blood pressure. Systemic vascular resistance separated survivors from nonsurvivors but cardiac index did not. A toe temperature that did not reach 32 degrees C within 4 hours of operation was associated with increased mortality. With peripheral warm-up patterns a nomogram was constructed, its predictive accuracy was identified [99% valid] and the tow temperature trends were correlated with traditional monitoring techniques. The authors conclude that measurement of tow temperature is a useful, inexpensive and noninvasive addition to established methods of monitoring after open-heart operations.
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D014034:Toes / Q000098:blood supply; D014655:Vascular Resistance