Perfusion index in preterm newborns: predictive value for morbimortality and association with Apgar score at five minutes and CRIB-II score
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Keywords

perfusion index
pulse oximeter
post-ductal
preterm
mortality
morbidity

How to Cite

Costa Monteiro, S., Correia-Costa, L., & Proença, E. (2019). Perfusion index in preterm newborns: predictive value for morbimortality and association with Apgar score at five minutes and CRIB-II score. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM), 8(1), e080104. https://doi.org/10.7363/080104

Abstract

Introduction: Perfusion index (PI) is a noninvasive indirect method of microcirculation measurement that might have a potential to predict morbimortality in preterm newborns. This study aims: 1) to define a critical value for post-ductal PI related to the morbimortality in preterm newborns under 32 weeks; 2) to define a prognostic value for post-ductal PI to predict that risk of morbimortality; and 3) to associate post-ductal PI values with the Apgar score at five minutes and the Clinical Risk Index for Babies II (CRIB-II) score.

Material and methods: This is an observational study, with a prospective character, performed in a Neonatal Intensive Care Unit that enrolled 34 preterm newborns with less than 32 weeks admitted between 1st February 2016 and 1st February 2017. Post-ductal PI values were evaluated in the newborns’ feet at 24 hours of life. The Apgar score was registered at birth and CRIB-II score was calculated. The other clinical variables, including the presence of an adverse outcome and/or death, was assessed in clinical records.

Measurements and main results: We found significant correlations between post-ductal PI values, Apgar score at five minutes and CRIB-II score. The area under ROC curve was higher for CRIB-II score and lower for Apgar score at five minutes. The best cut-off points were: 1) post-ductal PI value ≤ 0.72; 2) Apgar score at five minutes < 6; and 3) CRIB-II score > 9. Preterms within these cohorts have higher rates of morbimortality. Post-ductal PI values ≤ 0.72 were an independent predictor of mortality in preterm newborns (p-value = 0.047).

Conclusions: This study suggests that post-ductal PI value ≤ 0.72 at 24 hours of life might be a potential predictor of morbimortality in preterm newborns. However, it is important to clarify that this study has a small representative population which can reduce the accuracy of the results. The very high morbimortality rate in this cohort is another strong limitation for the quality of the results.

https://doi.org/10.7363/080104
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