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The serial changes of perfusion index in preterm infants with patent ductus arteriosus: is perfusion index clinically
Demet Terek1, Ozge Altun Koroglu, Zulal Ulger
1Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova, Izmir, Turkey - mehmet.yalaz@ege.edu.tr.
Insights
Perfusion Index (PI) can help detect hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Lower PI levels in the first two days may indicate hsPDA, aiding treatment decisions and monitoring response.
Area of Science:
- Neonatal Physiology
- Cardiovascular Monitoring
- Pediatric Cardiology
Background:
- Perfusion Index (PI) reflects peripheral blood flow and may aid in early detection of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants.
- Timely diagnosis and treatment of hsPDA are crucial for improving outcomes in premature neonates.
Purpose of the Study:
- To evaluate the utility of Perfusion Index (PI) levels for the early detection of hsPDA in preterm infants.
- To assess the correlation between PI and hsPDA severity.
- To determine if PI can monitor treatment response in hsPDA patients.
Main Methods:
- A cohort of preterm infants (born before 36 weeks gestational age) underwent simultaneous PI measurement and echocardiography.
- Infants were categorized into three groups: no-PDA, non-hsPDA, and hsPDA based on echocardiographic findings.
- Physiological parameters including heart rate, mean arterial pressure, body temperature, oxygen saturation, and PI were recorded daily for four days.
Main Results:
- Overall PI significantly increased from day 1 to day 4 in all preterm infants.
- Significantly lower PI values were observed in the hsPDA group compared to the no-PDA group on days 1 and 2.
- The difference in PI between groups diminished after 48 hours of intravenous ibuprofen treatment, suggesting PI's role in monitoring treatment efficacy.
Conclusions:
- Perfusion Index (PI) shows promise as a non-invasive tool for predicting perfusion disorders associated with hsPDA in preterm infants.
- PI measurements can assist clinicians in making treatment decisions for hsPDA.
- PI is also valuable for monitoring the therapeutic response to hsPDA treatment.
Background:
Perfusion Index (PI) which reflects the peripheral blood flow may help early detection and treatment decision of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. The present study is designed to analyze the usefulness of PI level in early detection of hsPDA in preterm infants.
Methods:
Preterm infants born before 36 gestational weeks were assessed for PI and simultaneous echocardiography. Based on echocardiography, each infant is categorized into no-PDA (group 1), non-hsPDA (group 2) and hsPDA (group 3). Heart rate (HR), mean arterial pressure (MAP), body temperature and oxygen saturation (SpO2) and concomitant PI were measured on days 1, 2, 3 and 4.
Results:
In all preterm infants (N.=42) PI significantly increased from 0.7 on day 1 to 1.4 on day 4. The HR did not change by the days; however, the MAP increased on days 3 and 4 compared to day 1. In hsPDA group, the median PI was 0.7 (IQR, 0.4) on day 1 compared to 0.9 (IQR, 0.2) on day 2. PI is significantly lower in hsPDA group compared to no-PDA group on day 1 and 2; however, this difference disappeared at 48 hour on the intravenous ibuprofen treatment (on day 3 and 4).
Conclusions:
PI may predict the perfusion disorder and help to decide for treatment of hsPDA and was also helpful to monitor the response to treatment in hsPDA patients.
