Peripheral Perfusion Index – Magic Wand in Prediction of Shock?

Ismail, Javed; Sankar, Jhuma

doi:10.1007/s12098-019-03028-w

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…This is important as the vast majority of COVID 19 patients may not be diagnosed with a cardiovascular complication due to the limitations in health infrastructure (19). Previous studies on non-Covid shock patients have found that PI could be used as a measure to predict onset of shock or to mark its severity (20)(21)(22). Studies have shown that PI has been found useful in post-surgical care of patients where hemodynamic monitoring is required (23,24).…”

Section: Discussionmentioning

confidence: 99%

Use of peripheral perfusion index (PI) as a predictor of cardiovascular complications in hospitalised Covid 19 patients - A pilot study

Menon¹,

Divya²

2022

Biomedicine

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Introduction and Aim: Cardiovascular complications have been associated with fatality in Covid-19 patients. Reduced peripheral perfusion is a marker for cardiovascular dysfunction. Peripheral Perfusion Index (PI) is a non-invasive measure of microvascular perfusion with regards to pulsatile arterial blood flow. The study was aimed at finding the utility of PI as a hemodynamic marker in Covid-19. Materials and Methods: Observational study done on 58 hospitalised adult Covid-19 patients over a span of 6 days. Each day the hemodynamic parameters such as pulse rate, SpO2 and Peripheral Perfusion Index (PI) were measured using a finger pulse oximeter. Peripheral Blood pressure was measured using automated BP apparatus. Mean Arterial Pressure (MAP) and pulse pressure (PP) was calculated. Results: Correlation between PI and other parameters checked using Pearson’s test. There was significant positive correlation between PI and PP in day wise analysis during first 2 days with linear regression showing PP can be predicted as a dependant function from PI. This shows the association between PI and systemic cardiovascular function. Conclusion: PI is a useful measure of peripheral microvascular perfusion and relates to systemic PP. It can be predicted from the results that PI can act as a reliable guide to predict the cardiovascular condition of the patient. As PI is measured from finger pulse oximeter, it is a non-invasive and easy-to-record method, which can be used by untrained personnel in Covid-19 patients.

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Section: Discussionmentioning

confidence: 99%

Use of peripheral perfusion index (PI) as a predictor of cardiovascular complications in hospitalised Covid 19 patients - A pilot study

Menon¹,

Divya²

2022

Biomedicine

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“…Furthermore, many of these signs are influenced by various factors, including type of shock (hypovolemic, cardiogenic, or vasodilatory), its etiology, body temperature, and ambient temperature. Moreover, each of these clinical signs, when considered alone, has poor sensitivity and specificity for predicting shock, which makes it preferable to consider a combination of these signs (1,2). Pediatric shock was categorized either: compensated with normal blood pressure, poor skin perfusion (CRT >2 s, mottled, cool peripheries, peripheral cyanosis), weak peripheral pulse, age specific tachycardia, tachypnoea, and oliguria or decompensated with hypotension (SBP < 70 þ (2Â age in years) mm Hg and decreased mental status (3).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Tissue Perfusion Using the Peripheral Perfusion Index and Lactate Clearance in Shock in Pediatric Patients

Bazaraa

Roby

Salah

et al. 2021

Shock

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Background: Pediatric shock has a high mortality rate because many of the early clinical signs are subtle and have poor sensitivity and specificity. Pediatric shock was categorized either: compensated with normal blood pressure, poor skin perfusion (CRT >2 s, mottled, cool peripheries, peripheral cyanosis), weak peripheral pulse, age specific tachycardia, tachypnoea, and oliguria or decompensated with hypotension (SBP < 70 þ (2Â age in years) mm Hg and decreased mental status. The perfusion index is a non-invasive method for assessing peripheral perfusion and may be a useful marker for identifying shock early in pediatric patients. Objective: This prospective cohort study (November 2019 to August 2020) evaluated whether the perfusion index, lactate, and/or lactate clearance could predict mortality among pediatric shock patients. Methods: Fifty children (68% male) with shock underwent assessments at presentation to the emergency room to evaluate their heart rate, blood pressure, capillary refill time, central venous pressure, perfusion index, cardiac index, systemic vascular resistance, central venous oxygen saturation, and lactate clearance. Results: The perfusion index range was 0.03 to 2.2 and 0.18 as the cut-off for mortality prediction providing 74% sensitivity and 78% specificity. The serum lactate concentration range was 0 to 16 mmol/L and >5.7 mmol/L as the cut-off for mortality prediction provided 70% sensitivity and 96% specificity at presentation to the emergency room. The lactate clearance range was 3% to 75% and >10% as the cut-off for survival prediction after resuscitation and at 6 h later. Conclusion: Perfusion index (PI), lactate, and lactate clearance provided comparable sensitivity and specificity for predicting outcomes among pediatric patients with shock Therefore, we suggest that the PI is an inexpensive, rapid, and non-invasive tool that can be used to predict illness severity and mortality in busy pediatric intensive care units and emergency departments. This tool may guide better patient triage and an earlier diagnosis of shock in this setting.

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Peripheral Perfusion Index – Magic Wand in Prediction of Shock?

Cited by 2 publications

References 7 publications

Use of peripheral perfusion index (PI) as a predictor of cardiovascular complications in hospitalised Covid 19 patients - A pilot study

Use of peripheral perfusion index (PI) as a predictor of cardiovascular complications in hospitalised Covid 19 patients - A pilot study

Assessment of Tissue Perfusion Using the Peripheral Perfusion Index and Lactate Clearance in Shock in Pediatric Patients

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