生长迟缓低体重儿外周灌注、心脏活动、氧饱和度、体温曲线和体位之间的相互作用。
Interactions among peripheral perfusion, cardiac activity, oxygen saturation, thermal profile and body position in growing low birth weight infants.
机构信息
Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
出版信息
Acta Paediatr. 2010 Jan;99(1):135-9. doi: 10.1111/j.1651-2227.2009.01514.x.
AIMS
To investigate the correlation between the 'perfusion index' (PI) and other commonly used estimates of cutaneous blood flow [heart rate (HR), surface temperatures (ST) and central-to-peripheral thermal gradients (C-P grad)] and to use this new non-invasive tool to compare differences between prone and supine sleep position in low birth weight (LBW) infants.
METHODS
Six-hour continuous recordings of pulse oximetry, cardiac activity and absolute ST from three sites (flank, forearm and leg), along with minute-to-minute assessment of behavioural states were performed in 31 LBW infants. Infants were randomly assigned to the prone or supine position for the first 3 h and then reversed for the second 3 h. PI data were correlated with HR and C-P grad, and compared across sleep positions during quiet sleep (QS) and active sleep (AS).
RESULTS
Perfusion index correlated significantly with HR (r(2) = 0.40) and flank-to-forearm thermal gradient (r(2) = 0.28). In the prone position during QS, infants exhibited higher PI (3.7 +/- 0.9 vs. 3.1 +/- 0.7), HR (158.4 +/- 8.9 vs. 154.1 +/- 8.8 bpm), SpO(2) (95.8 +/- 2.6 vs. 95.2 +/- 2.6%), flank (36.7 +/- 0.4 vs. 36.5 +/- 0.4 degrees C), forearm (36.1 +/- 0.6 vs. 35.5 +/- 0.4 degrees C) and leg (35.4 +/- 0.7 vs. 34.7 +/- 0.7 degrees C) temperatures and narrower flank-to-forearm (0.6 +/- 0.4 vs. 0.9 +/- 0.3 degrees C) and flank-to-leg (1.3 +/- 0.6 vs. 1.8 +/- 0.7 degrees C) gradients, compared to those of the supine position. Similar differences were observed during AS.
CONCLUSION
Perfusion index is a good non-invasive estimate of tissue perfusion. Prone sleeping position is associated with a higher PI, possibly reflecting thermoregulatory adjustments in cardiovascular control. The effects of these position-related changes may have important implications for the increased risk for sudden infant death syndrome in prone position.
目的
研究“灌注指数”（PI）与其他常用皮肤血流估计值（心率[HR]、表面温度[ST]和中心-外周温度梯度[C-P 梯度]）之间的相关性，并利用这种新的非侵入性工具来比较低出生体重（LBW）婴儿仰卧和俯卧睡眠姿势之间的差异。
方法
对 31 名 LBW 婴儿进行了 6 小时连续脉搏血氧饱和度、心脏活动和三个部位（侧腹、前臂和腿部）的绝对 ST 记录，以及每分钟行为状态的评估。婴儿被随机分配到俯卧或仰卧位，前 3 小时采用一种姿势，然后后 3 小时改为另一种姿势。PI 数据与 HR 和 C-P 梯度相关，并在安静睡眠（QS）和活跃睡眠（AS）期间比较不同睡眠姿势下的结果。
结果
PI 与 HR（r²=0.40）和侧腹-前臂温度梯度（r²=0.28）显著相关。在 QS 期间俯卧位时，婴儿的 PI（3.7±0.9 比 3.1±0.7）、HR（158.4±8.9 比 154.1±8.8 bpm）、SpO₂（95.8±2.6 比 95.2±2.6%）、侧腹（36.7±0.4 比 36.5±0.4°C）、前臂（36.1±0.6 比 35.5±0.4°C）和腿部（35.4±0.7 比 34.7±0.7°C）温度以及侧腹-前臂（0.6±0.4 比 0.9±0.3°C）和侧腹-腿部（1.3±0.6 比 1.8±0.7°C）梯度较仰卧位时更宽。在 AS 期间也观察到类似的差异。
结论
PI 是组织灌注的良好非侵入性估计值。俯卧睡眠姿势与较高的 PI 相关，可能反映了心血管控制的体温调节调整。这些与位置相关的变化的影响可能对俯卧位婴儿猝死综合征风险增加具有重要意义。
Zotero 插件