Photoplethysmographic assessment of pulse transit time correlates with echocardiographic measurement of stroke volume in preterm infants with patent ductus arteriosus

Abstract

Objective: We aimed to correlate photoplethysmographic parameters with stroke volume in infants with PDA. Photoplethysmography constitutes the optical signal in pulse oximetry.

Study design: Stroke volume was determined echocardiographically. Pulse transit time, right hand to foot arrival time difference, and relative amplitude were measured from pulse oximeter and ECG waveforms. Photoplethysmographic parameters before and after PDA closure were compared with stroke volume.

Results: After PDA closure, pulse transit time to the hand and to the foot were prolonged (54.7 ± 6.7 vs 65.5 ± 9.8 ms, p < 0.001, 82.5 ± 12.8 vs 88.6 ± 10.6 ms, p = 0.03), arrival time difference decreased (27.7 ± 7.6 vs 23.1 ± 5.6 ms, p = 0.021), and relative amplitude decreased (from 2.1 ± 0.7% to 1.5 ± 0.5%, p = 0.003). The time-based photoplethysmographic parameters correlated with stroke volume.

Conclusions: Photoplethysmographic waveform parameters are significantly different before and after PDA closure and the time-based parameters correlate well with stroke volume. Monitoring pulse transit time may assist in evaluation for spontaneous PDA closure or response to therapy.