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. 2023 Sep;112(9):1884-1891.
doi: 10.1111/apa.16856. Epub 2023 May 29.

Role of perfusion index and plethysmography variability index for predicting outcomes in neonatal sepsis

Shiv Sajan Saini  1 , Amit Kumar Shrivastav  1 , Venkataseshan Sundaram  1 , Sourabh Dutta  1 , Praveen Kumar  1
Affiliations

Role of perfusion index and plethysmography variability index for predicting outcomes in neonatal sepsis

Shiv Sajan Saini et al. Acta Paediatr. 2023 Sep.

Abstract

Aim: (i) To compare perfusion index (PI) and plethysmography variability index (PVI) between neonates with proven or probable sepsis versus no-sepsis, (ii) to examine an association of PI and PVI with in-hospital mortality.

Methods: We enrolled neonates with clinically presumed sepsis. Culture-proven or probable sepsis were categorised as 'cases' and no-sepsis as 'controls'. PI and PVI were recorded hourly for 120 h and averaged in 20-time epochs (0-6 h to 115-120 h).

Results: We analysed 148 neonates with sepsis (proven sepsis = 77, probable sepsis = 71) and 126 with no-sepsis. Neonates with proven/probable sepsis and no-sepsis had comparable PI and PVI values. Among 148 neonates with sepsis, 43 (29%) died. Non-survivors had significantly lower PI values than survivors (mean difference 0.21 [95% CI 0.14-0.29], p-value <0.001). PI had a significant but modest discriminative ability to identify non-survivors. However, PI did not independently predict mortality.

Conclusion: Neonates with proven/probable sepsis and no-sepsis had comparable PI and PVI values in the first 120 h of sepsis. PI but not PVI values were significantly lower in non-survivors than survivors. PI did not independently predict in-hospital mortality. Due to modest discriminative ability, PI should be interpreted along with other vital signs to take clinical decisions.

Keywords: PI; PVI; microcirculation; neonates; sepsis.

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References

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