Relation of dehydration degree with peripheral perfusion indexin children with acute gastroenteritis

Aim: It is planned to compare peripheral perfusion index measurements with the World Health Organization's Dehydration Scale in the evaluation of acute gastroenteritis-related dehydration in children to find distinctive cut-off values that can be used in dehydration and to investigate whether it is possible to benefit from the perfusion index as an objective indicator of response to intravenous fluid therapy. Methods: Patients diagnosed with acute gastroenteritis under the age of 5 (patient group) at Child Health and Diseases Polyclinics and Child Emergency Department of Hatay Mustafa Kemal University Hospital and healthy children under the age of 5 (control group) who applied to the polyclinics for routine examination were consecutively enrolled. Children with acute gastroenteritis are grouped as mild, moderate and severe dehydrate according to the World Health Organization Dehydration Scale. Perfusion index and vital parameters of all patients were measured before and after treatment, blood samples were taken for venous blood gases. Hemodynamic monitoring was done for 4 h. Peripheral PI, pulse and saturation of the control group were measured. Results: A total of 38 patients and 47 healthy child were included in the study, 47,3 % (18) of patients were girl, 52,7 % (20) were boy; 46,8 % (22) of the control group were girl, 53,2 % (25) were boy. The mean age of the patient group was 24.7 ± 19.4 months, and the mean age of the control group was 27.3 ± 21.3 months. 47,4% (18) of the patients were mild dehydrated, 26.3% (10) were moderate dehydrated and 26,3% (10) were severe dehydrated. As compared with the control group, patient group had a significantly lower perfusion index value on admission. Peripheral PI value of severe dehydrated patients increased significantly with fluid therapy. The ability of the perfusion index to predict dehydration was statistically significant according to the ROC analysis. Clinical gastroenteritis-related dehydration can be reasonably detected when perfusion index value is less than 1,15 in severe dehydration, less than 1,60 in moderate dehydration, less than 2,05 in mild dehydration in children less than 5 year of age. Conclusion: Perfusion index can be used as a non-invasive, continuous parameter to monitor peripheral perfusion in children, to detect gastroenteritis-related dehydration and to understand effectiveness of the treatment. Keywords: Perfusion index, Acute Gastroenteritis, Diarrhea, Pulse Oxymeter, Dehydration