Capillary blood gases in a pediatric intensive care unit.

OBJECTIVE: To determine if samples obtained from arterial and capillary sources are comparable in children with diverse pathologic conditions during their stay in a pediatric intensive care unit. STUDY DESIGN: Prospective, descriptive study in patients admitted to a multidisciplinary pediatric intensive care unit. INTERVENTIONS: Seventy-five simultaneous paired samples (arterial and capillary) were obtained from patients with different degrees of capillary reperfusion, hemodynamic stability, blood pressure, and temperature. Both samples were analyzed < or =5 mins after collection. MEASUREMENTS AND MAIN RESULTS: The average correlations between arterial and capillary samples were 0.87 for pH, 0.86 for CO2, and 0.65 for oxygen. Neither poor perfusion nor low temperature altered the correlation for pH or CO2. The only condition that significantly affected the correlation was hypotension. CONCLUSION: Capillary blood sampling is a useful alternative to gasometric evaluation of critically ill children, even in the presence of hypothermia or hypoperfusion, provided that hypotension is not present.

[The use of the Clinical Classification System in a pediatric intensive care unit]. / Uso del Sistema de Clasificación Clínica en una Unidad de Cuidados Intensivos Pediátrica.

All admissions to a pediatric intensive care unit (PICU) during a period of 33 months were retrospectively evaluated. We used the Clinical Classification System (CCS) at the time of admission; age, diagnosis, mortality and PICU stay were also evaluated. There were 1027 admissions: 794 (77.3%) with CCS-IV, 228 (22.2%) CCS-III and five (0.5%) CCS-II. The global mortality rate was 36.8%, being 46.3, 4.4 and 0% for groups IV, III and II, respectively. Mortality rate was significantly higher in group IV when compared with III (P < 0.001). Average PICU stay was 5.1 days (range: 0.5 hours-75 days), being higher in CCS-IV than in CCS-III (5.8 vs 2.7, P < 0.001). Comparing CCS with age and diagnosis, were found that mortality was significantly higher for any age group and diagnosis for CCS-IV than for III. The CCS allows to see statistical differences in mortality between groups III and IV, as well as PICU stay.