Paediatrica Indonesiana
Vol. 65 No. 6 (2025): November 2025

Perfusion index and lactate clearance as microcirculation parameters in pediatric post-cardiac correction surgery

Prawira, Yogi (Unknown)
Silawati, Trisna (Unknown)
Kaswandani2, Nastiti (Unknown)



Article Info

Publish Date
28 Dec 2025

Abstract

Background Congenital heart disease (CHD) is a common congenital anomaly in children, with corrective cardiac surgery using cardiopulmonary bypass (CPB) being the definitive treatment. However, post-operative morbidity and mortality remain high, requiring effective hemodynamic monitoring in the cardiac intensive care unit (CICU). Blood lactate levels are traditionally used to assess microcirculation, while non-invasive methods like the perfusion index (PI) have gained interest for real-time monitoring. Objective To determine the correlation between PI and blood lactate levels in pediatric patients following corrective cardiac surgery. Methods A prospective cohort study was conducted in the cardiac intensive care unit (CICU) at Cipto Mangunkusumo Hospital from September to October 2024. Thirty-four pediatric patients aged 1 month to 18 years who underwent corrective cardiac surgery were included. PI and lactate levels were measured at one, four, and eight hours post-operation. Results The median age of participants was 21.5 (IQR 10.25–79.5) months. Non-cyanotic CHD was the most common diagnosis (58%), and 67.6% of cases involved CPB. Low cardiac output syndrome occurred in 17.6% of subjects. Lactate levels decreased significantly over time (P<0.001), while PI showed an increasing trend. Correlation analysis revealed a significant negative correlation between PI <1.4 and lactate levels at the fourth (r =-0.455; P=0.038) and eighth hours (r=-0.515; P=0.017). Conclusion  PI has a significant negative correlation with lactate levels and may serve as a useful non-invasive parameter for microcirculation monitoring in pediatric patients after corrective cardiac surgery.

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Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...