den Boogert Wilhelmina J, van Elteren Hugo A, Goos Tom G, Reiss Irwin K M, de Jonge Rogier C J, van den Berg Victor J
Division of Neonatology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Room Sp-3434, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.
J Clin Monit Comput. 2018 Jun;32(3):457-464. doi: 10.1007/s10877-017-0058-3. Epub 2017 Aug 31.
The aim was to assess the reproducibility of the Pleth Variability Index (PVI), developed for non-invasive monitoring of peripheral perfusion, in preterm neonates below 32 weeks of gestational age. Three PVI measurements were consecutively performed in stable, comfortable preterm neonates in the first 48 h of life. On each occasion, pulse oximeter sensors were attached to two different limbs for 5 min. Reproducibility was assessed with the intra-class correlation coefficient (ICC) and Bland-Altman analysis. A total of 25 preterm neonates were included. Inter-limb comparison showed fair to moderate ICC's with 95%-confidence intervals (95%-CI). Left hand-right hand ICC = 0.498, 95%-CI (0.119-0.753); right foot-right hand ICC = 0.314 (-0.088-0.644); right foot-left foot ICC = 0.315 (-0.089-0.628). Intra-limb comparison showed fair to moderate ICC for right foot-right foot ICC = 0.380 (-0.014-0.677); and good ICC for right hand-right hand ICC = 0.646 (0.194-0.852). Bland-Altman plots showed moderate reproducibility of measurements between different limbs and of the same limb in consecutive time periods, with large biases and wide limits of agreement. The findings from this study indicate that PVI measurement is poorly reproducible when measured on different limbs and on the same limb in stable and comfortable preterm neonates.
目的是评估用于外周灌注无创监测的 pleth 变异指数（PVI）在胎龄小于 32 周的早产儿中的可重复性。在出生后 48 小时内，对稳定、舒适的早产儿连续进行三次 PVI 测量。每次测量时，将脉搏血氧饱和度传感器连接到两个不同的肢体上 5 分钟。使用组内相关系数（ICC）和 Bland-Altman 分析评估可重复性。共纳入 25 例早产儿。肢体间比较显示 ICC 为中等，95%置信区间（95%-CI）。左手-右手 ICC = 0.498，95%-CI（0.119 - 0.753）；右脚-右手 ICC = 0.314（-0.088 - 0.644）；右脚-左脚 ICC = 0.315（-0.089 - 0.628）。肢体内比较显示右脚-右脚 ICC 为中等，ICC = 0.380（-0.014 - 0.677）；右手-右手 ICC 为良好，ICC = 0.646（0.194 - 0.852）。Bland-Altman 图显示不同肢体之间以及同一肢体在连续时间段内测量的可重复性中等，偏差较大且一致性界限较宽。本研究结果表明，在稳定、舒适的早产儿中，在不同肢体和同一肢体上测量 PVI 时，其可重复性较差。
