Neonatology Department, Arnaud de Villeneuve Hospital, CHU, Montpellier, France.
Acta Paediatr. 2013 Apr;102(4):373-8. doi: 10.1111/apa.12130. Epub 2013 Jan 19.
The perfusion index (PI) and its dynamic change during respiration, and supressed the plethysmographic variability index (PVI), are calculated from pulse oximetry, and these indexes were recently proposed for continuous and noninvasive assessment of peripheral perfusion in neonates. We aimed to assess the effect of patent ductus arteriosus (PDA) on PI and PVI, according to ductal Doppler flow pattern.
Forty-five neonates with median (Q25-75) gestational age (GA) and birthweight of 27 (25-28) weeks and 857 (750-1080) grams, respectively, were assessed prospectively using serial echocardiography and pulse oximetry during the first postnatal week.
Perfusion index increased from 0.70 (0.50-1.05) at day 1 to 1.50 (1.0-2.00) at day 7 (p < 0.01) and was not influenced by ductal flow pattern. PVI was 22 (18-27) and did not vary during the study period but differed according to ductal flow pattern, with lower values in the growing and pulsatile groups compared with the pulmonary hypertension (p < 0.05), closing and closed groups (p < 0.01).
Ductal persistence and flow pattern did not affect PI but did affect PVI in preterm neonates of less than 29 weeks of GA. Future studies are needed to establish the usefulness of PVI in the early detection and management of PDA in preterm neonates.
灌注指数（PI）及其在呼吸过程中的动态变化，以及抑制容积描记变异指数（PVI），是从脉搏血氧饱和度计算得出的，这些指数最近被提出用于连续和无创评估新生儿的外周灌注。我们旨在根据动脉导管多普勒血流模式评估动脉导管未闭（PDA）对 PI 和 PVI 的影响。
前瞻性评估 45 例胎龄（GA）中位数（Q25-75）为 27 周（25-28 周）和出生体重为 857 克（750-1080 克）的新生儿，在出生后第一周内使用连续超声心动图和脉搏血氧饱和度进行评估。
PI 从第 1 天的 0.70（0.50-1.05）增加到第 7 天的 1.50（1.0-2.00）（p < 0.01），不受动脉导管血流模式的影响。PVI 为 22（18-27），在研究期间没有变化，但根据动脉导管血流模式不同而不同，与肺动脉高压组（p < 0.05）、关闭和闭合组（p < 0.01）相比，生长和搏动组的 PVI 值较低。
动脉导管持续存在和血流模式不会影响 PI，但会影响 GA 小于 29 周的早产儿的 PVI。未来的研究需要确定 PVI 在早产儿 PDA 的早期发现和管理中的有用性。
