Correlation of peripheral perfusion index and mortality of patients with shock in Pediatric Intensive Care Unit of NICH, Karachi, Pakistan.

Abstract

Objective: To investigate the correlation between peripheral perfusion index (PPI) and mortality among pediatric shock patients admitted to the pediatric intensive care unit (PICU). Study Design: Prospective, Observational study. Setting: The PICU of National Institute of Child Health, Karachi, Pakistan. Period: March 2024 to February 2025. Methods: A total of 64 children aged between 1 month to 18 years and admitted to the PICU with a diagnosis of shock were analyzed. The PPI was categorized as mild (≥1.4), moderate (>0.6 to <1.4), and critical (≤0.6). At the time of admission, demographic, clinical parameters and vitals were documented. Saturation and perfusion index were noted on admission and during the course of illness in PICU. PPI was measured using pulse oximeter. Results: In a total of 64 children, 38 (59.4%) were female, with an overall mean age of 7.39±4.57 years. The mean baseline PPI was 0.97±0.66. Critical perfusion was found to have significant association with higher heart rate (p=0.036), lower systolic (p=0.007) and diastolic blood pressures (p=0.043), higher PRISM III scores (p<0.001), increased need for mechanical ventilation (p=0.014), longer PICU stays (p=0.006), and higher mortality rates (p=0.036). Lower PPI values were significantly correlated with higher heart rate (r=–0.407; p=0.001), lower systolic blood pressure (r=0.352; p=0.004), lower diastolic blood pressure (r=0.289; p=0.021), higher PRISM III scores (r=–0.676; p<0.001), and longer PICU stays (r=–0.296; p=0.018). Conclusion: Lower baseline PPI values (<0.6) were significantly associated with adverse hemodynamic parameters, increased severity of illness scores, greater need for mechanical ventilation, and higher mortality rates.