Plethysmography variability index (PVI) changes in preterm neonates with shock-an observational study

Area of Science:

• Neonatal physiology
• Pediatric critical care
• Hemodynamic monitoring

Background:

• Shock diagnosis in neonates is challenging, particularly in preterm infants.
• The sensitivity of current shock detection methods in neonates is not well-established.
• Plethysmography Variability Index (PVI) is used in children but its role in neonates requires definition.

Purpose of the Study:

• To evaluate changes in Plethysmography Variability Index (PVI) in preterm neonates experiencing shock.
• To assess the utility of PVI as a bedside parameter for shock management in this population.

Main Methods:

• Prospective observational study involving 37 preterm neonates.
• Monitoring of PVI, mean blood pressure, pulse pressure, arterial blood gas pH, and base deficit.
• Analysis of PVI changes during shock onset and resolution.

Main Results:

• At shock onset, mean PVI was 28% (±5) with no hypotension observed.
• Upon shock resolution in 31 infants, 96.77% showed a decrease in PVI by an average of 11% (±5).
• A significant proportion of neonates exhibited increased PVI at shock onset.

Conclusions:

• Preterm neonates with shock may show an increase in PVI at the onset.
• Decreased PVI correlates with shock resolution.
• PVI shows promise as a valuable bedside monitoring tool for preterm infants with shock.