The perfusion index of healthy term infants during transition at birth.
Perfusion index is a continuous parameter provided by pulse oximetry and might be useful for evaluating hemodynamic changes at birth and identifying transitional problems. The objective was to describe perfusion index values in term infants immediately after birth. Perfusion index of 71 healthy term born infants were recorded during the first 10 min after birth, using a pulse oximetry sensor placed preductally. A Wilcoxon signed-rank test was used to compare between time points. No significant trend in perfusion index could be observed in term-delivered infants. There was a significant difference between 2 and 3 min (2.4 (1.6-5.0) vs. 2.3 (1.6-3.7), p = 0.05) and between 3 and 4 min after birth (2.3 (1.6-3.7) vs. 2.1 (1.4-3.2), p < 0.001). There was no significant change in median PI values in the following 8 min.


CONCLUSIONS
Perfusion index does not change significantly during transition at birth in healthy term infants born by normal vaginal delivery or cesarean section. Large variation in perfusion index causes monitoring this parameter to have limited value.


BACKGROUND
• Perfusion index is a non-invasive indicator for peripheral perfusion. • Perfusion index values <1.24 are seen as an accurate predictor for severity of illness for infants admitted to the neonatal intensive care unit. What is new: • Although significant physiological changes occur during birth, perfusion index remains stable. • Large variation in perfusion index causes monitoring of this value to have limited value as an additional parameter for evaluating transition at birth.
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Jacco K
JK
Kroese
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC, Leiden, The Netherlands. j.j.van_vonderen@lumc.nl.
Jeroen J
JJ
van Vonderen
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Ilona C
IC
Narayen
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Frans J
FJ
Walther
MIMR-PHI Institute for Medical Research, Monash University, Clayton, Victoria, Australia.
Stuart
S
Hooper
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Arjan B
AB
te Pas
D036861:Delivery, Obstetric; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000032:analysis*; D012016:Reference Values; D012189:Retrospective Studies; D047929:Term Birth / Q000502:physiology*; D013997:Time Factors
D010100:Oxygen
Heart rate; Neonatal transition; Newborn; Oxygen saturation; Perfusion index