Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction
Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction
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DOI：
10.1111/j.1651-2227.2007.00439.x
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发表时间：
2007-10-01
期刊：
影响因子：
3.8
通讯作者：
Ostman-Smith, I.
中科院分区：
文献类型：
--
作者：
Granelli, A. de-Wahl;Ostman-Smith, I.
目的：外周灌注指数（PPI）被认为是检测引起循环窘迫疾病的可能方法。我们旨在建立该指标在健康新生儿中的正常范围，并将其与有导管依赖体循环的新生儿进行比较。设计：我们进行了病例对照研究。背景：我们的研究人群包括来自瑞典Vastra Gotaland的1万名新生儿。患者：共10000例正常新生儿和9例导管依赖性体循环患儿（左心梗阻性疾病[LHOD]组）参与研究。方法：我们在出院前使用新一代脉搏血氧仪（Masimo Radical SET）对PPI进行单次产前和产后测量。结果：1 ~ 120 h PPI值呈不对称的非正态分布，PPI中位数为1.70，四分位数区间为1.18 ~ 2.50。第5百分位= 0.70，第95百分位= 4.50。LHOD组所有婴儿的产前或产后PPI均低于四分位数范围，9名婴儿中有5名（56%）低于第5个百分位数的临界值0.70 （p < 0.0001， Fisher精确检验）。PPI值< 0.70，LHOD的优势比为23.75 （95% CI 6.36-88.74）。结论：PPI值低于0.70可能提示疾病，< 0.50（第一个百分位数）提示灌注不足。PPI值可能是早期检测LHOD的一个有用的附加工具。
Aim: Peripheral perfusion index (PPI) has been suggested as a possible method to detect illness causing circulatory embarrassment. We aimed to establish the normal range of this index in healthy newborns, and compare it with newborns with duct-dependent systemic circulation.Design: We conducted a case-control study.Setting: Our study population comprised 10 000 prospectively recruited newborns from Vastra Gotaland, Sweden.Patients: A total of 10 000 normal newborns and 9 infants with duct-dependent systemic circulation (left heart obstructive disease [LHOD] group) participated in the study.Methods: We conducted single pre- and postductal measurements of PPI with a new generation pulse oximeter (Masimo Radical SET) before discharge from hospital.Results: PPI values between 1 and 120 h of age show an asymmetrical, non-normal distribution with median PPI value of 1.70 and interquartile range of 1.18-2.50. The 5th percentile = 0.70 and 95th percentile = 4.50. All infants in the LHOD group had either pre- or postductal PPI below the interquartile range, and 5 of 9 (56%) were below the 5th percentile cut-off of 0.70 (p < 0.0001, Fisher's exact test). A PPI value < 0.70 gave an odds ratio for LHOD of 23.75 (95% CI 6.36-88.74).Conclusion: PPI values lower than 0.70 may indicate illness and a value < 0.50 (1st percentile) indicates definite underperfusion. PPI values might be a useful additional tool for early detection of LHOD.