Division of Neonatology, Department of Maternal and Perinatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
J Perinatol. 2010 Apr;30(4):265-9. doi: 10.1038/jp.2009.159. Epub 2009 Nov 12.
Superior vena cava (SVC) flow is used as an index for evaluating systemic blood flow in neonates. Thus far, several reports have shown that low SVC flow is a risk factor for intraventricular hemorrhage (IVH) in the preterm infant. Therefore, it is likely to be a useful index in the management of the preterm infant. The perfusion index (PI) derived from a pulse oximeter is a marker that allows noninvasive and continuous monitoring of peripheral perfusion. The objective of this paper was to determine the accuracy of the PI for detecting low SVC flow in very low birth weight infants born before 32 weeks of gestation.
We studied the correlation between PI and SVC flow 0 to 72 h after birth in very low birth weight infants born before 32 weeks of gestation. The best cut-off value for low SVC flow was calculated from the respective receiver-operating characteristic curves.
A positive correlation was found between the PI and SVC flow (r=0.509, P<0.001). The best cut-off value for the PI to detect low SVC flow was 0.44 (sensitivity 87.5%, specificity 86.3%, positive predictive value 38.9%, negative predictive value 98.6%).
This study found that the PI was associated with SVC flow, and it was a useful index for detecting low SVC flow in very low birth weight infants born before 32 weeks of gestation. Therefore, use of the PI should be evaluated in the cardiovascular management of the preterm infant.
上腔静脉（SVC）血流量被用作评估新生儿全身血流的指标。迄今为止，已有多项研究表明，低 SVC 血流量是早产儿脑室内出血（IVH）的危险因素。因此，它可能是早产儿管理的一个有用指标。来自脉搏血氧仪的灌注指数（PI）是一种允许对周围灌注进行非侵入性和连续监测的标志物。本文旨在确定 PI 在检测妊娠 32 周前出生的极低出生体重儿低 SVC 流量中的准确性。
我们研究了妊娠 32 周前出生的极低出生体重儿出生后 0 至 72 小时内 PI 与 SVC 流量之间的相关性。从各自的受试者工作特征曲线计算出低 SVC 流量的最佳截断值。
PI 与 SVC 流量呈正相关（r=0.509，P<0.001）。PI 检测低 SVC 流量的最佳截断值为 0.44（灵敏度 87.5%，特异性 86.3%，阳性预测值 38.9%，阴性预测值 98.6%）。
本研究发现 PI 与 SVC 流量相关，是检测妊娠 32 周前出生的极低出生体重儿低 SVC 流量的有用指标。因此，应在早产儿心血管管理中评估 PI 的使用。
