title: Relationship between perfusion index and patent ductus arteriosus in preterm infants.
abstract: BACKGROUND
  Perfusion index (PI) is a noninvasive measure of perfusion. ΔPI (difference between pre- and postductal PI) may identify hemodynamically significant PDA. However, studies are limited to brief and intermittent ΔPI sampling. Our objective is to assess the value of continuous high resolution ΔPI monitoring in the diagnosis of PDA.
  
  
  METHODS
  Continuous ΔPI monitoring in preterm infants was prospectively performed using two high-resolution pulse oximeters. Perfusion Index measures (ΔPI mean and variability, pre- and postductal PI) were analyzed over a 4-h period prior to echocardiography. A cardiologist blinded to the results evaluated for PDA on echocardiography. Linear mixed regression models were utilized for analyses.
  
  
  RESULTS
  We obtained 31 echocardiography observations. Mean ΔPI (-0.23 vs. 0.16; P < 0.05), mean pre-PI (0.86 vs. 1.26; P < 0.05), and ΔPI variability (0.39 vs. 0.61; P = 0.05) were lower in infants with PDA compared to infants without PDA at the time of echocardiography.
  
  
  CONCLUSIONS
  Mean ΔPI, ΔPI variability, and mean pre-PI measured 4 h prior to echocardiography detect PDA in preterm infants. PI is dynamic and should be assessed continuously. Perfusion index is a promising bedside measurement to identify PDA in preterm infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Enrique
authors.initials: E
authors.lastname: Gomez-Pomar
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Majd
authors.initials: M
authors.lastname: Makhoul
authors.affiliation: Department of Biostatistics, University of Kentucky, Lexington, Kentucky.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Westgate
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Katrina T
authors.initials: KT
authors.lastname: Ibonia
authors.affiliation: Biomedical Engineering, University of Kentucky, Lexington, Kentucky.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Patwardhan
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Giannone
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Henrietta S
authors.initials: HS
authors.lastname: Bada
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.
authors.forename: Elie G
authors.initials: EG
authors.lastname: Abu Jawdeh
mesh_terms: D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation; D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D000067716:Point-of-Care Testing; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010100:Oxygen