The serial changes of perfusion index in preterm infants with patent ductus arteriosus: is perfusion index clinically significant?
BACKGROUND
Perfusion Index (PI) which reflects the peripheral blood flow may help early detection and treatment decision of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. The present study is designed to analyze the usefulness of PI level in early detection of hsPDA in preterm infants.


METHODS
Preterm infants born before 36 gestational weeks were assessed for PI and simultaneous echocardiography. Based on echocardiography, each infant is categorized into no-PDA (group 1), non-hsPDA (group 2) and hsPDA (group 3). Heart rate (HR), mean arterial pressure (MAP), body temperature and oxygen saturation (SpO2) and concomitant PI were measured on days 1, 2, 3 and 4.


RESULTS
In all preterm infants (N.=42) PI significantly increased from 0.7 on day 1 to 1.4 on day 4. The HR did not change by the days; however, the MAP increased on days 3 and 4 compared to day 1. In hsPDA group, the median PI was 0.7 (IQR, 0.4) on day 1 compared to 0.9 (IQR, 0.2) on day 2. PI is significantly lower in hsPDA group compared to no-PDA group on day 1 and 2; however, this difference disappeared at 48 hour on the intravenous ibuprofen treatment (on day 3 and 4).


CONCLUSIONS
PI may predict the perfusion disorder and help to decide for treatment of hsPDA and was also helpful to monitor the response to treatment in hsPDA patients.
Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova, Izmir, Turkey - mehmet.yalaz@ege.edu.tr.
Demet
D
Terek
Ozge
O
Altun Koroglu
Zulal
Z
Ulger
Mehmet
M
Yalaz
Nilgun
N
Kultursay
D061605:Administration, Intravenous; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007231:Infant, Newborn; D007234:Infant, Premature; D012039:Regional Blood Flow; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen