title: [Use of laser Doppler to assess peripheral tissue perfusion in critically ill children].
abstract: OBJECTIVE
  To analyze skin tissue perfusion at different sites in critically ill children.
  
  
  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.
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: García-Figueruelo
authors.forename: J
authors.initials: J
authors.lastname: Urbano
authors.forename: M
authors.initials: M
authors.lastname: Botrán
authors.forename: R
authors.initials: R
authors.lastname: González-Cortés
authors.forename: M J
authors.initials: MJ
authors.lastname: Solana
authors.forename: J
authors.initials: J
authors.lastname: López-González
authors.forename: J
authors.initials: J
authors.lastname: López-Herce
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler