Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Neonatology. 2013;104(4):250-4. doi: 10.1159/000353862. Epub 2013 Sep 21.
Perfusion index (PI) could reflect peripheral flow. Preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) will have left-to-right shunt across PDA causing less blood flow to the lower legs.
To evaluate pre- and postductal PI differences (ΔPI) in hsPDA.
Preterm infants with gestational age <34 weeks were assessed for ΔPI on days 1, 3, and 7 of life with simultaneous echocardiography. Based on echocardiography, each infant was categorized into hsPDA, non-hsPDA, and no PDA.
Thirty infants (16 males), median age 31 weeks (interquartile range, IQR, 29-32) and weight 1,490 g (IQR 1,100-1,670) were enrolled. On days 1 and 3 of life, the ΔPI of infants with hsPDA (1.57%, IQR 0.28-2.32, n = 14, and 1.32%, IQR 0.28-1.83, n = 10) were significantly higher than those without hsPDA (0.14%, IQR -0.03 to 0.30, n = 16, and 0.08%, IQR -0.07 to 0.26, n = 20), p = 0.009 and 0.005, respectively. At all time points (days 1, 3, and 7 of life, n = 84), ΔPI >1.05% had sensitivity, specificity, positive predictive value, and negative predictive value of 66.7, 100, 100, and 86.4%, respectively, to detect hsPDA.
The pre- and postductal PI differences were significantly related to the hemodynamic changes of PDA and might be useful to detect hemodynamically significant PDA.
灌注指数（PI）可以反映外周血流。患有动脉导管未闭（PDA）的早产儿会出现左向右分流，导致下肢血流减少。
评估 PDA 分流的前、后导管 PI 差异（ΔPI）。
对胎龄 <34 周的早产儿在出生后第 1、3 和 7 天进行 PI 评估，同时进行超声心动图检查。根据超声心动图，将每个婴儿分为 PDA 分流显著（hsPDA）、非 hsPDA 和无 PDA。
共纳入 30 名婴儿（男婴 16 名），中位胎龄为 31 周（四分位距 IQR，29-32），体重为 1490g（IQR 1100-1670）。在出生后第 1 和第 3 天，hsPDA 婴儿的 ΔPI（1.57%，IQR 0.28-2.32，n=14，和 1.32%，IQR 0.28-1.83，n=10）明显高于非 hsPDA 婴儿（0.14%，IQR -0.03 至 0.30，n=16，和 0.08%，IQR -0.07 至 0.26，n=20），p=0.009 和 0.005。在所有时间点（出生后第 1、3 和 7 天，n=84），ΔPI>1.05%检测 hsPDA 的敏感性、特异性、阳性预测值和阴性预测值分别为 66.7%、100%、100%和 86.4%。
前、后导管 PI 差异与 PDA 的血流动力学变化密切相关，可能有助于检测 PDA 分流显著。
