Early dynamic changes in pulse oximetry signals in preterm newborns with histologic chorioamnionitis

Felice, Claudio De; Goldstein, Mitchell; Parrini, Stefano; Verrotti, Alberto; Criscuolo, Mario; Latini, Giuseppe

doi:10.1097/01.pcc.0000201002.50708.62

Cited by 24 publications

(15 citation statements)

References 55 publications

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“…Our group assessed the reproducibility of PI values in preterm infants less than 32 weeks 55. We found the median (IQR) PI for the entire cohort was 0.70 (0.29–1.35), values similar to those of De Felice et al 47. We also determined that this measurement was highly reproducible and that the measurements obtained in the right upper limb were consistently higher than either lower limb, which might reflect transitional circulatory changes.…”

Section: Pulsatility Index (Pi)supporting

confidence: 67%

Objective cardiovascular assessment in the neonatal intensive care unit

Dempsey

El-Khuffash²

2017

Arch Dis Child Fetal Neonatal Ed

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Traditionally, cardiovascular well-being was essentially based on whether the mean blood pressure was above or below a certain value. However, this singular crude method of assessment provides limited insight into overall cardiovascular well-being. Echocardiography has become increasingly used and incorporated into clinical care. New objective modality assessments of cardiovascular status continue to evolve and are being evaluated and incorporated into clinical care. In this review article, we will discuss some of the recent advances in objective assessment of cardiovascular well-being, including the concept of multimodal monitoring. Sophisticated haemodynamic monitoring systems are being developed, including mechanisms of data acquisition and analysis. Their incorporation into clinical care represents an exciting next stage in the management of the infant with cardiovascular compromise.

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Section: Pulsatility Index (Pi)supporting

confidence: 67%

Objective cardiovascular assessment in the neonatal intensive care unit

Dempsey

El-Khuffash²

2017

Arch Dis Child Fetal Neonatal Ed

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“…In pulse oximetry, PI is a scalar value derived from magnitude of the pulsations displayed on the plethysmographic wave form by calculation from the ratio of the amount of infrared signal light absorbed by pulsating arterial flow (pulsatile component) to the amount of infrared signal light absorbed by skin, other tissues, and venous blood (nonpulsatile component) [7]. The upper and lower limits of PI for Masimo Radical signal extraction technology reported by the manufacturer are 0.02-20.00%.…”

Section: Methodsmentioning

confidence: 99%

“…Echocardiography remains the gold standard in the diagnosis of PDA by demonstration of PDA by two-dimensional and color Doppler flow echocardiography [2,3,4,5]. Over the past decades, pulse oximetry has been widely used in neonatal intensive care units and sick newborn nurseries [6,7]. The perfusion index (PI) derived from the signal of the pulse oximetery is a noninvasive and continuous monitoring of the peripheral perfusion [8,9].…”

Section: Introductionmentioning

confidence: 99%

Perfusion Index as a Diagnostic Tool for Patent Ductus Arteriosus in Preterm Infants

Khositseth

Muangyod²,

Nuntnarumit³

2013

Neonatology

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Background: Perfusion index (PI) could reflect peripheral flow. Preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) will have left-to-right shunt across PDA causing less blood flow to the lower legs. Objective: To evaluate pre- and postductal PI differences (ΔPI) in hsPDA. Methods: Preterm infants with gestational age <34 weeks were assessed for ΔPI on days 1, 3, and 7 of life with simultaneous echocardiography. Based on echocardiography, each infant was categorized into hsPDA, non-hsPDA, and no PDA. Results: Thirty infants (16 males), median age 31 weeks (interquartile range, IQR, 29-32) and weight 1,490 g (IQR 1,100-1,670) were enrolled. On days 1 and 3 of life, the ΔPI of infants with hsPDA (1.57%, IQR 0.28-2.32, n = 14, and 1.32%, IQR 0.28-1.83, n = 10) were significantly higher than those without hsPDA (0.14%, IQR -0.03 to 0.30, n = 16, and 0.08%, IQR -0.07 to 0.26, n = 20), p = 0.009 and 0.005, respectively. At all time points (days 1, 3, and 7 of life, n = 84), ΔPI >1.05% had sensitivity, specificity, positive predictive value, and negative predictive value of 66.7, 100, 100, and 86.4%, respectively, to detect hsPDA. Conclusion: The pre- and postductal PI differences were significantly related to the hemodynamic changes of PDA and might be useful to detect hemodynamically significant PDA.

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“…In addition, gait studies in aging and diseased states such as Huntington's disease, Parkinson's disease, amyotrophic lateral sclerosis [7,23,24] have shown that stride-to-stride variability is altered by these processes. Such alterations have also been noted in other medical domains such as cardiology (assessment of heart rate variability), neurology (assessment of electroencephalographic data variability), pediatrics (assessment of pulse oximetry signals in preterm newborns for the prediction of histologic chorioamnionitis), and endocrinology (assessment of hormone secretion variability) [2,6,8,12,16,34,50,51]. Thus, it has been proposed that chaotic properties characterize healthy systems, where the variability observed provides flexibility to adapt to everyday stresses placed on the human body [41].…”

Section: Introductionmentioning

confidence: 99%

ACL deficiency affects stride-to-stride variability as measured using nonlinear methodology

Moraiti

Stergiou

Ristanis

et al. 2007

Knee Surg Sports Traumatol Arthr

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Previous studies suggested that the small fluctuations present in movement patterns from one stride to the next during walking can be useful in the investigation of various pathological conditions. Previous studies using nonlinear measures have resulted in the development of the "loss of complexity hypothesis" which states that disease can affect the variability and decrease the complexity of a system, rendering it less able to adjust to the ever changing environmental demands. The nonlinear measure of the Lyapunov Exponent (LyE) has already been used for the assessment of stride-to-stride variability in the anterior cruciate ligament (ACL) deficient knee in comparison to the contralateral intact knee. However, there is biomechanical evidence that after ACL rupture, adaptations are also present in the contralateral intact knee. Thus, our goal was to investigate stride-to-stride variability in the ACL deficient knee as compared to a healthy control knee. Seven subjects with unilateral ACL deficiency and seven healthy controls walked at their self-selected speed on a treadmill, while three-dimensional knee kinematics was collected for 80 consecutive strides. A nonlinear measure, the largest LyE was calculated from the resulted knee joint flexion-extension data of both groups. Larger LyE values signify increased variability and increased sensitivity to initial conditions. Our results showed that the ACL deficient group exhibited significantly less variable walking patterns than the healthy control. These changes are not desirable because they reflect decreases in system's complexity, which indicates narrowed functional responsiveness, according to the "loss of complexity hypothesis." This may be related with the increased future pathology found in ACL deficient patients. The methods used in the present paper showed great promise to assess the gait handicap in knee injured patients.

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Early dynamic changes in pulse oximetry signals in preterm newborns with histologic chorioamnionitis

Abstract: Our findings indicate that early autonomic tone balance abnormalities are present in newborns with HCA and suggest that early dynamic analysis of pulse oximetry signals could be useful in identifying affected infants.

Cited by 24 publications

References 55 publications

Objective cardiovascular assessment in the neonatal intensive care unit

Objective cardiovascular assessment in the neonatal intensive care unit

Perfusion Index as a Diagnostic Tool for Patent Ductus Arteriosus in Preterm Infants

ACL deficiency affects stride-to-stride variability as measured using nonlinear methodology

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