Terek Demet, Altun Koroglu Ozge, Ulger Zulal, Yalaz Mehmet, Kultursay Nilgun
Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova, Izmir, Turkey -
Minerva Pediatr. 2016 Aug;68(4):250-5.
Perfusion Index (PI) which reflects the peripheral blood flow may help early detection and treatment decision of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. The present study is designed to analyze the usefulness of PI level in early detection of hsPDA in preterm infants.
Preterm infants born before 36 gestational weeks were assessed for PI and simultaneous echocardiography. Based on echocardiography, each infant is categorized into no-PDA (group 1), non-hsPDA (group 2) and hsPDA (group 3). Heart rate (HR), mean arterial pressure (MAP), body temperature and oxygen saturation (SpO2) and concomitant PI were measured on days 1, 2, 3 and 4.
In all preterm infants (N.=42) PI significantly increased from 0.7 on day 1 to 1.4 on day 4. The HR did not change by the days; however, the MAP increased on days 3 and 4 compared to day 1. In hsPDA group, the median PI was 0.7 (IQR, 0.4) on day 1 compared to 0.9 (IQR, 0.2) on day 2. PI is significantly lower in hsPDA group compared to no-PDA group on day 1 and 2; however, this difference disappeared at 48 hour on the intravenous ibuprofen treatment (on day 3 and 4).
PI may predict the perfusion disorder and help to decide for treatment of hsPDA and was also helpful to monitor the response to treatment in hsPDA patients.
反映外周血流的灌注指数（PI）可能有助于早产儿中具有血流动力学意义的动脉导管未闭（hsPDA）的早期检测和治疗决策。本研究旨在分析PI水平在早产儿hsPDA早期检测中的作用。
对孕周小于36周的早产儿进行PI评估及同步超声心动图检查。根据超声心动图结果，将每个婴儿分为无动脉导管未闭组（第1组）、非hsPDA组（第2组）和hsPDA组（第3组）。在第1、2、3和4天测量心率（HR）、平均动脉压（MAP）、体温、血氧饱和度（SpO2）及相应的PI。
在所有42例早产儿中，PI从第1天的0.7显著增加到第4天的1.4。心率在各天无变化；然而，与第1天相比，第3天和第4天的平均动脉压升高。在hsPDA组，第1天的PI中位数为0.7（四分位间距[IQR]，0.4），而第2天为0.9（IQR，0.2）。与无动脉导管未闭组相比，hsPDA组在第1天和第2天的PI显著较低；然而，在静脉注射布洛芬治疗48小时后（第3天和第4天），这种差异消失。
PI可预测灌注障碍，有助于hsPDA的治疗决策，也有助于监测hsPDA患者的治疗反应。
