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Perfusion index in newborns with CHD without clinical signs of hypoperfusion and heart failure: comparison with healthy newborns
Published online by Cambridge University Press: 17 July 2023
Abstract
Introduction:
Peripheral perfusion index has been proposed as a possible method for detecting circulatory impairment. We aimed to determine the normal range of peripheral perfusion index in healthy newborns and compare it with that of newborns with CHD.
Methods:
Right-hand saturation and right-hand peripheral perfusion index levels were recorded, and physical examination and echocardiography were performed in newborns who were 0–28 days old and whom were evaluated in our paediatric cardiology outpatient clinic. The saturation and peripheral perfusion index levels of newborns with normal heart anatomy and function were compared with those of newborns with CHD.
Results:
Out of 358 newborns (238 mature and 75 premature) enrolled in the study, 39 had CHD (20 mild CHD, 13 moderate CHD, and 6 severe CHD), of which 29 had CHD with left-to-right shunting, 5 had obstructive CHD, and 5 had cyanotic CHD. No newborn had clinical signs of hypoperfusion or heart failure, such as prolonged capillary refill, weakened pulses, or coldness of extremities. Peripheral perfusion index level was median (interquartile range) 1.7 (0.6) in healthy newborns, 1.8 (0.7) in newborns with mild CHD, and 1.8 (0.4) in newborns with moderate and severe CHD, and there was no significant difference between the groups regarding peripheral perfusion index level.
Conclusion:
Peripheral perfusion index remains unchanged in newborns with CHD without the clinical signs of hypoperfusion or heart failure. Larger studies with repeated peripheral perfusion index measurements can determine how valuable this method will be in the follow-up of newborns with CHD.
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- © The Author(s), 2023. Published by Cambridge University Press
References
Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.10.1016/S0735-1097(02)01886-7CrossRefGoogle ScholarPubMed
Gómez-Gutiérrez, R, Galindo-Hayashi, JM, Cantú-Reyna, C, Vazquez-Cantu, DL, Britton-Robles, C, Cruz-Camino, H. Critical CHD screening programme: a 3-year multicentre experience in Mexico. Cardiol Young 2022; 8: 1–7.Google Scholar
Ewer, AK. Perfusion index as a screening test for neonatal aortic coarctation: should we be using it routinely? Acta paediatr 2021; 110: 1716–1717.10.1111/apa.15768CrossRefGoogle ScholarPubMed
Olive, MK, Owens, GE. Current monitoring and innovative predictive modeling to improve care in the pediatric cardiac intensive care unit. Transl Pediatr 2018; 7: 120–128.CrossRefGoogle ScholarPubMed
Ehrmann, DE, Leopold, DK, Phillips, R, et al. The compensatory reserve index responds to acute hemodynamic changes in patients with congenital heart disease: a proof of concept study. Pediatr Cardiol 2020; 41: 1190–1198.10.1007/s00246-020-02374-3CrossRefGoogle ScholarPubMed
Zaramella, P, Freato, F, Quaresima, V, et al. Foot pulse oximeter perfusion index correlates with calf muscle perfusion measured by near-infrared spectroscopy in healthy neonates. J Perinatol 2005; 25: 417–422.10.1038/sj.jp.7211328CrossRefGoogle ScholarPubMed
Cresi, F, Pelle, E, Calabrese, R, Costa, L, Farinasso, D, Silvestro, L. Perfusion index variations in clinically and hemodynamically stable preterm newborns in the first week of life. Ital J Pediatr 2010; 36: 6.10.1186/1824-7288-36-6CrossRefGoogle ScholarPubMed
Singh, J, Jain, S, Chawla, D, Randev, S, Khurana, S. Peripheral perfusion index as a marker of sepsis in preterm neonates. J Trop Pediatr 2022; 68: fmac014.10.1093/tropej/fmac014CrossRefGoogle ScholarPubMed
Hakan, N, Dilli, D, Zenciroglu, A, Aydin, M, Okumus, N. Reference values of perfusion indices in hemodynamically stable newborns during the early neonatal period. Eur J Pediatr 2014; 173: 597–602.CrossRefGoogle ScholarPubMed
Cresti, A, Giordano, R, Koestenberger, M, et al. Incidence and natural history of neonatal isolated ventricular septal defects: do we know everything? A 6-year single- center Italian experience follow-up. Congenit Heart Dis 2018; 13: 105–112.10.1111/chd.12528CrossRefGoogle ScholarPubMed
Cantinotti, M, Giordano, R, Emdin, M, et al. Echocardiographic assessment of pediatric semilunar valve disease. Echocardiography 2017; 34: 1360–1370.10.1111/echo.13527CrossRefGoogle ScholarPubMed
Cave, AT, Lowenstein, SA, McBride, C, Michaud, J, Madriago, EJ, Ronai, C. Pulse oximetry screening and critical congenital heart disease in the state of Oregon. Clin Pediatr 2021; 60: 290–297.10.1177/00099228211008704CrossRefGoogle ScholarPubMed
Narin, N, Pamukçu, Ö., Baykan, A, et al. Transcatheter closure of PDA in premature babies less than 2 kg. Anatol J Cardiol 2017; 17: 147–153.Google ScholarPubMed
Corsini, I, Cecchi, A, Coviello, C, Dani, C. Perfusion index and left ventricular output correlation in healthy term infants. Eur J Pediatr 2017; 176: 1013–1018.10.1007/s00431-017-2920-1CrossRefGoogle ScholarPubMed
Jegatheesan, P, Nudelman, M, Goel, K, Song, D, Govindaswami, B. Perfusion index in healthy newborns during critical congenital heart disease screening at 24 hours: retrospective observational study from the USA. BMJ Open 2017; 21: 7, e017580.Google Scholar
Schena, F, Picciolli, I, Agosti, M, et al. Perfusion index and pulse oximetry screening for congenital heart defects. J Pediatr 2017; 183: 74–79.10.1016/j.jpeds.2016.12.076CrossRefGoogle ScholarPubMed
Osman, AA, Albalawi, M, Dakshinamurti, S, et al. The perfusion index histograms predict patent ductus arteriosus requiring treatment in preterm infants. Eur J Pediatr 2021; 180: 1747–1754.10.1007/s00431-021-03937-zCrossRefGoogle ScholarPubMed
Granelli, ADW, Östman-Smith, I. Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction. Acta Paediatr 2007; 96: 1455–1459.CrossRefGoogle ScholarPubMed
Uygur, O, Koroglu, OA, Levent, E, et al. The value of peripheral perfusion index measurements for early detection of critical cardiac defects. Pediatr Neonatol 2019; 60: 68–73.CrossRefGoogle ScholarPubMed
Lannering, K, Elfvin, A, Mellander, M. Low false-positive rate of perfusion index as a screening tool for neonatal aortic coarctation. Acta Paediatr 2021; 110: 1788–1794.CrossRefGoogle ScholarPubMed
Siefkes, H, Kair, L, Tancredi, DJ, et al. Oxygen saturation and perfusion index-based enhanced critical congenital heart disease screening. Am J Perinatol 2020; 37: 158–165.Google ScholarPubMed
De Felice, C, Latini, G, Vacca, P, Kopotic, RJ. The pulse oximeter perfusion index as a predictor for high illness severity in neonates. Eur J Pediatr 2002; 161: 561–562.10.1007/s00431-002-1042-5CrossRefGoogle ScholarPubMed
Argun et al. supplementary material
Argun et al. supplementary material
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