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Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction
Author(s) -
Granelli A deWahl,
ÖstmanSmith I
Publication year - 2007
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00439.x
Subject(s) - medicine , interquartile range , percentile , cardiology , odds ratio , population , perfusion , peripheral , hypoplastic left heart syndrome , heart disease , statistics , mathematics , environmental health
Abstract 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 Västra Götaland, 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.