title: Perfusion Index-Bedside Diagnosis of Hemodynamically Significant Patent Ductus Arteriosus.
abstract: Patent ductus arteriosus (PDA) is a significant problem in preterm babies <34 weeks old. Echocardiogram (echo) is the gold standard for diagnosing PDA. Perfusion index (PI) using a pulse oximeter could aid in diagnosing a hemodynamically significant PDA (HsPDA).
  
  
  
  To evaluate the accuracy of delta-PI (ΔPI; pre-ductal - post-ductal PI) in diagnosing HsPDA in preterm babies <34 weeks old.
  
  
  
  Prospective analytical cross-sectional (observational) study.
  
  
  
  Preterm infants <34 weeks old (n = 27) were enrolled in the study after parental consent. ΔPI was calculated on Days 1 and 3. Babies are categorized into two groups-HsPDA and no HsPDA based on echo on Day 3.
  
  
  
  The mean gestational ages were 30.4 ± 1.9 (HsPDA) and 31.7 ± 1.6 weeks (no HsPDA), and birth weights were 1.23 ± 0.32 kg and 1.43 ± 0.34 kg, respectively (p > 0.05). Ten infants had HsPDA. The ΔPI values in Groups A and B differed significantly on Days 1 and 3 (Day 1: 1.06 ± 0.3 vs. 0.54 ± 0.2 and Day 3: 1.11 ± 0.15 vs. 0.57 ± 0.3). The area under the receiver operating characteristic curve was significant for ΔPI on Days 1 and 3. The ΔPI > 0.85 on Day 1 and > 0.95 on Day 3 had a sensitivity and specificity of 80% and 94% and 80% and 88.2%, respectively, for diagnosing HsPDA.
  
  
  
  ΔPI is a useful, simple parameter, which could help in the assessment of PDA in preterm babies.
authors.affiliation: Department of Neonatology, St. John's Medical College Hospital, Bangalore 560034, India chakri1111balla@gmail.com.
authors.forename: Kalyan Chakravarthy
authors.initials: KC
authors.lastname: Balla
authors.affiliation: Department of Cardiology, St. John's Medical College Hospital, Bangalore 560034, India.
authors.forename: Vinu
authors.initials: V
authors.lastname: John
authors.affiliation: Department of Neonatology, St. John's Medical College Hospital, Bangalore 560034, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Rao Pn
authors.affiliation: Department of Cardiology, St. John's Medical College Hospital, Bangalore 560034, India.
authors.forename: Kiron
authors.initials: K
authors.lastname: Varghese
mesh_terms: D003430:Cross-Sectional Studies; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D010092:Oximetry; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology*; D012372:ROC Curve; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity
keywords: HsPDA; echo; perfusion index; preterm; ΔPI