Knobel-Dail Robin B, Tanaka David T, Holditch-Davis Diane, White John
1 Duke University School of Nursing, Durham, NC, USA.
2 Duke University School of Medicine, Durham, NC, USA.
Biol Res Nurs. 2017 Jan;19(1):45-52. doi: 10.1177/1099800416656914. Epub 2016 Jul 26.
Our program of research focuses on thermal and circulatory stability in extremely premature infants. In prior studies, we found that infants have long periods of time in which foot temperature (FT) is higher than central temperature. We thus wanted to determine whether blood flow in the foot is increased when FT is elevated. Perfusion index (PI) can be used as a clinical indicator of peripheral perfusion, but reports on use of PI in premature infants are lacking. We employed exploratory methodology to examine foot perfusion and temperature in very low birth weight infants.
For premature infants after birth: (1) describe foot PI values for the first 2 weeks of life and (2) describe the relationship of longitudinal FT and PI.
Case study design with longitudinal FT and PI in 17 infants born at <29 weeks' gestation with birth weight < 1,200 g for 2 weeks after birth.
Infants averaged 851 g at birth and were 24-29 weeks' gestational age. The mean PI across all infants for 14 days was 1.04, SD = 0.79. Using a repeated measures multilevel model approach confirmed that FT and PI were positively related in these infants.
These findings demonstrate that perfusion is increased in the periphery in extremely premature infants when FT is increased. PI measures can be used as a trend for peripheral perfusion, and these values increase over the first 2 weeks of life in infants weighing more than 750 g.
我们的研究项目聚焦于极早产儿的体温和循环稳定性。在之前的研究中,我们发现婴儿在很长一段时间内足部温度(FT)高于中心温度。因此,我们想确定当FT升高时足部血流量是否增加。灌注指数(PI)可作为外周灌注的临床指标,但缺乏关于PI在早产儿中应用的报道。我们采用探索性方法来研究极低出生体重儿的足部灌注和温度。
针对出生后的早产儿:(1)描述出生后前2周的足部PI值,(2)描述FT和PI的纵向关系。
对17例孕龄<29周、出生体重<1200g的婴儿出生后2周进行FT和PI纵向监测的病例研究设计。
婴儿出生时平均体重851g,孕龄24 - 29周。所有婴儿14天的平均PI为1.04,标准差=0.79。采用重复测量多级模型方法证实,这些婴儿的FT和PI呈正相关。
这些发现表明,极早产儿FT升高时外周灌注增加。PI测量可作为外周灌注的一个趋势指标,体重超过750g的婴儿在出生后的前2周内这些值会升高。