학술논문
Assesment of Pleth Variablity Index in Moderate-late Preterm Infants/ Orta-Gec Preterm Infantlarda Pletismografik Variabilite Indeksi Degerlendirilmesi
Original Article/Orijinal Arastirma
Original Article/Orijinal Arastirma
Document Type
Academic Journal
Author
Source
Forbes Journal of Medicine. April 2023, Vol. 4 Issue 1, p84, 5 p.
Subject
Language
English
ISSN
2717-9443
Abstract
INTRODUCTION Pulse oximetry has been used in neonatal monitoring for many years. It is the most widely used non-invasive method to monitor critically ill patients. (1-2) The signal consists of [...]
Objective: The pleth variability index (PVI) allows the non-invasive detection of hemodynamic changes but is not yet commonly used in neonates. This study determined reference values for PVI in spontaneously breathing moderate to late preterm newborns during the first 12 hours of life and evaluate the relationship between these values and respiratory morbidity. Methods: The study included infants born at 32-37 weeks of gestation who had good spontaneous respiratory effort, were hemodynamicaUy stable and were hospitalized in a tertiary neonatal intensive care unit. PVI, perfusion index (PI), oxygen saturation, and heart rate were prospectively monitored every 2 s for the first 12 h postnatally. Basic characteristic findings were obtained from patient records. Results: Data from a total of 58 patients were analyzed. The mean PVI was 21 [+ or -] 4.3% and mean PI was 0. 85 [+ or -] 0.25%. Comparison of patients who required respiratory support (n=43) and those who received no respiratory support (n = 15) showed that the heart rate (137.5 [+ or -] 10.6 vs. 129.7 [+ or -] 9.6, p=0.01) is significantly higher and PI (0.8 [+ or -] 0.2% vs. 0.9 [+ or -] 0.3%, p=0.03) is significantly lower in the respiratory support group. Moreover, PVI levels were found to be slightly higher in infants who get respiratory support (21.7 [+ or -] 4.5% vs. 19.2 [+ or -] 3.2%, p=0.05). Conclusion: PVI can be successfully measured in moderate-to late preterm newborns. More extensive studies are needed to obtain information on the clinical use of PVI, interpretation of abnormal results, its association with neonatal morbidities, and treatment management. Keywords: Preterm, pleth variability index, pulse oximeter Amac: Pletismografik variabilite indeksi (PVI) hemodinamik degisiklikleri non-invaziv olarak tespit edebilen, yenidoganlarda henuz sik olarak kullanilmayan bir aractir. Bu calismanin amaci yasamin ilk 12 saati boyunca spontan soluyan ilimli ve/veya gec preterm yenidoganlarda PVI icin referans degerleri belirlenmesi ve bu degerlerin solunumsal morbiditeler ile iliskisinin saptanmasidir. Yontem: Ucuncu basamak yenidogan yogun bakim unitesinde yatirilarak izlenen 32-37 gebelik haftalari arasinda dogmus, spontan solunum cabasi iyi olan, hemodinamik olarak stabil olan bebekler dahil edildi. Prospektif kesitsel olarak hayatin ilk 12 saati boyunca perfuzyon indeksi (PI), PVI, oksijen saturasyonu ve kalp hizi; 2 saniyede bir olcum yapilacak sekilde monitorize edildi. Temel karakteristik bulgular hasta kayitlarindan elde edildi. Bulgular: Toplam 58 hastanin verisi analiz edildi. Ortalama PVI degeri 21 [+ or -] 4,3, PI degeri ise 0,85 [+ or - ] 0,25 olarak bulundu. Invaziv olmayan solunum destegi gerektiren (n=43) ve hic solunum destegi almayan (n = 15) hastalar kiyaslandiginda kalp hizi, saturasyon, PI benzer bulunurken; PVI (21,7 [+ or -] 4,5 ve 19,2 [+ or -] 3,2) degeri solunum destegi alanlarda daha yuksek olmasina ragmen istatistiksel anlama ulasmadi (p=0,05). Sonuc: PVI ilimli ve gec preterm yenidoganlarda basarili sekilde olculebilmektedir. PVI'nin klinik kullanimi, anormal sonuclarin yorumlanmasi, yenidogan bebeklerde morbiditeler ile iliskisi ve tedavi yonetimi ile ilgili bilgi verecek daha genis kapsamli calismalara ihtiyac vardir. Anahtar Kelimeler: Preterm, pletismografik variabilite indeksi, nabiz oksimetre
Objective: The pleth variability index (PVI) allows the non-invasive detection of hemodynamic changes but is not yet commonly used in neonates. This study determined reference values for PVI in spontaneously breathing moderate to late preterm newborns during the first 12 hours of life and evaluate the relationship between these values and respiratory morbidity. Methods: The study included infants born at 32-37 weeks of gestation who had good spontaneous respiratory effort, were hemodynamicaUy stable and were hospitalized in a tertiary neonatal intensive care unit. PVI, perfusion index (PI), oxygen saturation, and heart rate were prospectively monitored every 2 s for the first 12 h postnatally. Basic characteristic findings were obtained from patient records. Results: Data from a total of 58 patients were analyzed. The mean PVI was 21 [+ or -] 4.3% and mean PI was 0. 85 [+ or -] 0.25%. Comparison of patients who required respiratory support (n=43) and those who received no respiratory support (n = 15) showed that the heart rate (137.5 [+ or -] 10.6 vs. 129.7 [+ or -] 9.6, p=0.01) is significantly higher and PI (0.8 [+ or -] 0.2% vs. 0.9 [+ or -] 0.3%, p=0.03) is significantly lower in the respiratory support group. Moreover, PVI levels were found to be slightly higher in infants who get respiratory support (21.7 [+ or -] 4.5% vs. 19.2 [+ or -] 3.2%, p=0.05). Conclusion: PVI can be successfully measured in moderate-to late preterm newborns. More extensive studies are needed to obtain information on the clinical use of PVI, interpretation of abnormal results, its association with neonatal morbidities, and treatment management. Keywords: Preterm, pleth variability index, pulse oximeter Amac: Pletismografik variabilite indeksi (PVI) hemodinamik degisiklikleri non-invaziv olarak tespit edebilen, yenidoganlarda henuz sik olarak kullanilmayan bir aractir. Bu calismanin amaci yasamin ilk 12 saati boyunca spontan soluyan ilimli ve/veya gec preterm yenidoganlarda PVI icin referans degerleri belirlenmesi ve bu degerlerin solunumsal morbiditeler ile iliskisinin saptanmasidir. Yontem: Ucuncu basamak yenidogan yogun bakim unitesinde yatirilarak izlenen 32-37 gebelik haftalari arasinda dogmus, spontan solunum cabasi iyi olan, hemodinamik olarak stabil olan bebekler dahil edildi. Prospektif kesitsel olarak hayatin ilk 12 saati boyunca perfuzyon indeksi (PI), PVI, oksijen saturasyonu ve kalp hizi; 2 saniyede bir olcum yapilacak sekilde monitorize edildi. Temel karakteristik bulgular hasta kayitlarindan elde edildi. Bulgular: Toplam 58 hastanin verisi analiz edildi. Ortalama PVI degeri 21 [+ or -] 4,3, PI degeri ise 0,85 [+ or - ] 0,25 olarak bulundu. Invaziv olmayan solunum destegi gerektiren (n=43) ve hic solunum destegi almayan (n = 15) hastalar kiyaslandiginda kalp hizi, saturasyon, PI benzer bulunurken; PVI (21,7 [+ or -] 4,5 ve 19,2 [+ or -] 3,2) degeri solunum destegi alanlarda daha yuksek olmasina ragmen istatistiksel anlama ulasmadi (p=0,05). Sonuc: PVI ilimli ve gec preterm yenidoganlarda basarili sekilde olculebilmektedir. PVI'nin klinik kullanimi, anormal sonuclarin yorumlanmasi, yenidogan bebeklerde morbiditeler ile iliskisi ve tedavi yonetimi ile ilgili bilgi verecek daha genis kapsamli calismalara ihtiyac vardir. Anahtar Kelimeler: Preterm, pletismografik variabilite indeksi, nabiz oksimetre