Department of Neonatology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu.
Department of Neonatology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu. Correspondence to: Dr Chandra Kumar Natarajan, Head of Department, Department of Neonatology, Kanchi Kamakoti CHILDS Trust Hospital, Nageshwara Road, Nungambakkam, Chennai, Tamil Nadu.
Indian Pediatr. 2023 May 15;60(5):364-368. Epub 2023 Jan 9.
To study the correlation of objective parameters for diagnosing shock viz., perfusion index (PI), plethysmography variability index (PVI) and serum lactate (SL) with invasive blood pressure in late preterm and term infants with shock.
Prospective observational study (diagnostic test) conducted at the neonatal intensive care unit of Kanchi Kamakoti CHILDS Trust Hospital, Chennai between June, 2018 and May, 2020. Term and late preterm neonates with shock were included in the study. PI, PVI, SL, SpO2 and heart rate were monitored. PI, PVI and SLL were recorded at 0,12, 24 and 72 hours of onset of shock. All the babies were followed up till discharge or death.
Total 78 neonates were enrolled in the study. At 0 hour, SL and PVI had negative correlation (P =0.002 and P=0.003) while PI had a weak-to-moderate positive correlation (P=0.002) with invasive blood pressure. SL ≥4.65 had a sensitivity of 75% and specificity of 75.8%, and PI <0.455 had a sensitivity of 65%, and specificity of 58.6% for predicting invasive hypotension. PVI ≥23.5 had a sensitivity of 90% and specificity of 63.8% in predicting invasive hypotension.
PI has moderate positive correlation while SL and PVI have moderate negative correlation with invasive blood pressure. The cutoff values of SL ≥4.65, PI <0.45 and PVI ≥23.5 can predict invasive hypotension with good sensitivity and negative predictive value.
研究诊断休克的客观参数（灌注指数[PI]、容积描记变异指数[PVI]和血清乳酸[SL]）与晚期早产儿和足月休克婴儿有创血压的相关性。
这是一项在钦奈 Kanchi Kamakoti CHILDS Trust 医院新生儿重症监护病房进行的前瞻性观察研究（诊断性试验），时间为 2018 年 6 月至 2020 年 5 月。纳入有休克的足月和晚期早产儿。监测 PI、PVI、SL、SpO2 和心率。在休克发生后 0、12、24 和 72 小时记录 PI、PVI 和 SL。所有婴儿均随访至出院或死亡。
本研究共纳入 78 例新生儿。在 0 小时时，SL 和 PVI 与有创血压呈负相关（P=0.002 和 P=0.003），而 PI 与有创血压呈弱至中度正相关（P=0.002）。SL≥4.65 预测有创低血压的敏感性为 75%，特异性为 75.8%，PI<0.455 的敏感性为 65%，特异性为 58.6%。PVI≥23.5 预测有创低血压的敏感性为 90%，特异性为 63.8%。
PI 与有创血压呈中度正相关，而 SL 和 PVI 与有创血压呈中度负相关。SL≥4.65、PI<0.45 和 PVI≥23.5 的截断值可预测有创低血压，具有良好的敏感性和阴性预测值。
