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早产患病新生儿灌注指数与临床风险指数Ⅱ评分的相关性:一项前瞻性队列研究

Correlation Between Perfusion Index and Clinical Risk Index for Babies II Score in Preterm Sick Neonates: A Prospective Cohort Study.

作者信息

Angadi Shambu S, Angadi Chaitra, Niranjan H S

机构信息

Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.

Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India. Correspondence to: Dr Chaitra Angadi, Department of Neonato-logy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

Indian Pediatr. 2024 Dec 15;61(12):1097-1102. Epub 2024 Sep 24.

Abstract

OBJECTIVES

This study aims to investigate the correlation between perfusion index (PI) and Clinical Risk Index for Babies (CRIB) II score in sick preterm neonates < 37-week gestation admitted to neonatal intensive care unit (NICU).

METHOD

This observational study was conducted over period of 18 months in a tertiary care centre. All eligible preterm neonates admitted to NICU were examined. The PI and CRIB II score for each neonate were documented. The primary outcome of the study was correlation between PI and CRIB II scores at admission.

RESULTS

383 neonates were enrolled in the study. Mean gestation of neonates was 32 weeks. A strong correlation between PI and CRIB II scores at admission was noted (P = 0.01). We demonstrated a strong association between PI at admission and predischarge mortality of neonates with 92.9% sensitivity and 70% specificity. Lower PI was associated with need of inotropes and invasive ventilation and longer duration of hospital stay. Combined use of PI and CRIB II predicted mortality with 83.3% sensitivity and 80.5% specificity.

CONCLUSION

The perfusion index is a potential bedside measure that correlated well with the CRIB II score, which is a validated tool to assess sick preterm neonates. Preductal PI at admission was associated with predischarge mortality, length of hospital stay, inotrope requirement and need for ventilator support in preterm neonates.

摘要

目的

本研究旨在调查入住新生儿重症监护病房(NICU)的孕周<37周的患病早产儿的灌注指数(PI)与婴儿临床风险指数(CRIB)II评分之间的相关性。

方法

本观察性研究在一家三级医疗中心进行了18个月。对所有入住NICU的符合条件的早产儿进行检查。记录每个新生儿的PI和CRIB II评分。本研究的主要结局是入院时PI与CRIB II评分之间的相关性。

结果

383名新生儿纳入本研究。新生儿的平均孕周为32周。观察到入院时PI与CRIB II评分之间存在强相关性(P = 0.01)。我们证明入院时的PI与新生儿出院前死亡率之间存在强关联,敏感性为92.9%,特异性为70%。较低的PI与需要使用血管活性药物和有创通气以及住院时间延长有关。联合使用PI和CRIB II预测死亡率的敏感性为83.3%,特异性为80.5%。

结论

灌注指数是一种潜在的床旁测量指标,与CRIB II评分密切相关,CRIB II评分是评估患病早产儿的有效工具。入院时的导管前PI与早产儿出院前死亡率、住院时间、血管活性药物需求和呼吸机支持需求有关。

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