Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province 212002, China.
Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province 212002, China.
J Clin Anesth. 2022 Sep;80:110852. doi: 10.1016/j.jclinane.2022.110852. Epub 2022 Apr 27.
To assess whether pulse perfusion index (PI) values could be employed to predict intrapartum fever and to provide a cut-off PI value for predicting intrapartum fever occurrence.
We conducted a single-center, prospective, observational study.
Delivery room at the Department of Obstetrics, Affiliated Hospital of Jiangsu University.
117 parturients who intended to have a vaginal delivery.
Each parturient received epidural analgesia.
We checked each parturient's tympanic temperature before analgesia (T), at 1 h (T) and 2 h (T) after analgesia, immediately at the end of the second (T) and third (T) stages of labor, and at 1 h postpartum (T). A temperature of ≥38°C was defined as fever. PI, measured on the right second toe, was recorded before analgesia (PI) and at 10 min (PI), 20 min (PI), and 30 min (PI) after analgesia. The PI change rate was calculated as the incremental change in PI from PI, divided by the PI. Receiver operating characteristic (ROC) curves were used to verify the utility of the PI and PI change rate values for predicting intrapartum fever.
We found that peak temperature (T) occurred at the end of the second or the third stage of labor. Within 30 min after analgesia, the PI showed a significant increase over time and there was a linear correlation between PI and T values (P < 0.001, r = 0.544). The PI, PI, PI and PI change rate in febrile parturients were higher than those in afebrile parturients (P < 0.001). The area under the ROC (AUROC) for PI was 0.818 (P < 0.001) with a cut-off of 9.30. The AUROC of the PI change rate was 0.738 (P < 0.001) with a cut-off of 3.45.
PI and PI change rate values could be used to predict intrapartum fever in parturients after epidural analgesia.
评估脉搏灌注指数（PI）值是否可用于预测产时发热，并为预测产时发热发生提供 PI 值截断值。
我们进行了一项单中心、前瞻性、观察性研究。
江苏大学附属医院产房。
117 名计划阴道分娩的产妇。
每位产妇均接受硬膜外镇痛。
镇痛前（T）、镇痛后 1 小时（T）和 2 小时（T）、第二产程末（T）和第三产程末（T）以及产后 1 小时（T）时，每位产妇均检测鼓膜温度。体温≥38°C 定义为发热。PI，在右侧第二趾上测量，在镇痛前（PI）和镇痛后 10 分钟（PI）、20 分钟（PI）和 30 分钟（PI）时记录。PI 变化率计算为 PI 从 PI 增量变化，除以 PI。受试者工作特征（ROC）曲线用于验证 PI 和 PI 变化率值预测产时发热的效用。
我们发现峰值体温（T）发生在第二产程或第三产程末。镇痛后 30 分钟内，PI 随时间呈显著增加趋势，PI 与 T 值之间存在线性相关（P<0.001，r=0.544）。发热产妇的 PI、PI、PI 和 PI 变化率均高于无热产妇（P<0.001）。PI 的 ROC 曲线下面积（AUROC）为 0.818（P<0.001），截断值为 9.30。PI 变化率的 AUROC 为 0.738（P<0.001），截断值为 3.45。
PI 和 PI 变化率值可用于预测硬膜外镇痛后产妇的产时发热。
