Validation of Peripheral Perfusion Index as a Noninvasive Screening Tool in Predicting Adverse Neonatal Outcome

Timely identification of suboptimal organ perfusion is crucial to detect adverse outcomes early and to prevent its long-term motor and cognitive effects. Peripheral perfusion index (PI) is a noninvasive screening tool which can identify babies at risk for hemodynamic compromise.

We aimed to study the validity of peripheral PI as an early predictor of adverse neonatal outcome in comparison with other commonly used noninvasive screening modalities such as heart rate (HR), respiratory rate, temperature, capillary refill time (CRT), and blood pressure.

This prospective observational study was carried out between January 2021 and May 2022. All infants born beyond 32 weeks of pregnancy who are admitted to the neonatal intensive care unit and needed hemodynamic were included in the study. Peripheral PI was monitored along with other noninvasive parameters at specific intervals and compared with those parameters for the degree of variation in each at specified time intervals and with the changing hemodynamic status of these babies including adverse outcomes.

A cohort of 93 neonates was enrolled in the study. Our study found lower PI values among newborns with adverse outcomes. This study also revealed negative correlations between HR and PI, suggesting that low PI could indicate early neonatal compromise and circulatory inadequacy. We also established positive correlations between PI and CRT, systolic blood pressure, mean arterial blood pressure, and pulse pressure.

PI can serve as a noninvasive screening tool which can identify babies at risk for hemodynamic compromise, especially in resource-poor settings.