Abstract
The perfusion index (PI) is a noninvasive marker derived from photoelectric plethysmographic signals in pulse oximetry in the evaluation of peripheral perfusion. This study was aimed to determine the correlation between PI and left ventricular output (LVO) in healthy late preterm infants at 48th hour of life. With new generation pulse oximeter (MASIMO Rad 7 Oximeter) pre- and post-ductal PI values were recorded from healthy late preterm babies at the 48th hour of life. PI was determined simultaneously with LVO as measured by transthoracic echocardiography. A total of 50 late preterm babies were included in the study. The mean gestational age of the cases was 35.4 ± 0.7 weeks and the birth weight was 2,586 ± 362 g. Mean pre- and post-ductal PI values at the postnatal 48th hour of babies' life were found to be 2.0 ± 0.9 and 1.7 ± 1.1. The mean LVO value was 438 ± 124, LVO/kg 175 ± 50. When the LVO value was normalized according to the babies' body weight, there was no statistically significant correlation between the pre- and post-ductal PI and the LVO/kg value (r <0.2, p >0.05 in both comparisons). There was no correlation between pre- and post-ductal PI and LVO values in healthy late preterm infants. This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies. · No correlation found between PI and LOV in preterm babies.. · LVO cannot adequately reflect peripheral blood flow.. · Sympathetic nervous system is immature in preterm infants..
Highlights
There was no correlation between pre- and post-ductal perfusion index (PI) and left ventricular output (LVO) values in healthy late preterm infants
This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies
It is suggested that PI may be a possible marker for screening critical congenital heart diseases with low left ventricular output (LVO)
Summary
Congenital heart diseases (CHD) are the most common birth defects, with a prevalence of approximately 1 percent of births. A major disadvantage of this screening method is that it cannot detect CHD even if it is at a critical level in patients with low left ventricular output (LVO) [4]. To detect these cases, it is recommended that SpO2 measurement be supplemented with perfusion index (PI) during screening [5]. It is suggested that PI may be a possible marker for screening critical CHD with low LVO [5] It is not known whether there is a correlation between PI and LVO in late preterm infants. A literature review showed that there was only one study in term infants on this topic [10], but no study in late preterm infants
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