Prediction of Shock by Peripheral Perfusion Index

Sivaprasath, P; Gounder, Raja Mookka; Mythili, B

doi:10.1007/s12098-019-02993-6

Cited by 23 publications

(33 citation statements)

References 10 publications

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“…Compared to other indicators that are used in guiding shock treatment, PPI is non-invasive and realtime. Studies on PPI have confirmed its significance on reflecting tissue perfusion in critically ill patients [6,15,16].…”

Section: Roc Analysesmentioning

confidence: 93%

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Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

Shi¹,

Xu²,

Yu³

et al. 2020

Preprint

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BackgroundPeripheral perfusion index (PPI) is associated with hypoperfusion in critical patients. Many researches focus on using PPI as a predictor in septic shock, but few studies report on its significance in surgical patients. We performed this study to find out association between PPI and surgical patients' prognoses. MethodsIt's a retrospective study from January to June 2019, on surgical patients transferred to ICU, Xinyang Central hospital, Henan province, China. The inclusive/exclusive criteria are followings, inclusive:1) age ≥18 years old; 2) surgical length ≥120min; Exclusive: 1) died in ICU; 2) discharging against medical advice; 3) existing diseases affecting blood flow of upper limbs, for example, vascular thrombus in arms; 4) severe liver dysfunction Patients were grouped according to their length of ICU stay (LOS ICU, >48h regarded as prolonged ICU stay, otherwise non-prolonged). Baseline characteristics (age, gender, comorbidity), surgical sites and length, SOFA and APACHE II on 1st day in ICU, LOS ICU, mean artery pressure (MAP), lactate clearance rate (LCR), peripheral perfusion index (PPI), temperature (axillary) were collected and compared between the 2 groups. Correlation and ROC (receiver operating characteristic) analysis was also performed. ResultsEventually, 72 patients were included, 30 in prolonged and 42 in non-prolonged group. Compared to non-prolong, patients in prolonged ICU stay group had higher lactate(6h: 3.70±0.52 vs 2.50±0.59 mmol/L, p<0.001; 12h: 2.78±0.50 vs 1.90±0.30 mmol/L, p<0.001), lower LCR(0-6h: -20%[-37%, 0%] vs 19%[9%, 31%], p<0.001) and PPI (0h: 0.80± 0.27 vs 1.47±0.43, p<0.001; 6h: 0.88±0.25 vs 1.57±0.40, p<0.001). No difference was found in gender, age, surgical length, SOFA, APACHE II, temperature and comorbidity. Averaged 1h and 6h PPI were strongly associated with LCR (0-6h, correlation coefficient 0.5521h and 0.4366h) and LOS ICU(correlation coefficient: -0.6391h and -0.5606h). The area under the receiver operating characteristic (AUC) of PPIT0 and PPIT1 for predicting prolonged ICU stay were 0.905 and 0.916 respectively. The cutoff values of PPIT0 and

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Section: Roc Analysesmentioning

confidence: 93%

“…Peripheral perfusion index (PPI) is an indicator reflecting hypoperfusion in critical patients [6]. It is measured using pulse co-oximetry technology which is characterized by being real-time and noninvasive.…”

Section: Backgroundsmentioning

confidence: 99%

Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

Shi¹,

Xu²,

Yu³

et al. 2020

Preprint

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“…As with any monitoring parameter, PI gains its clinical application in pediatric ICU with monitoring of its trends. Authors report an important finding that, a reduction of 57% from baseline PI is a predictor of impending shock [2]. We could presume that majority of these were in cold compensated shock because warm shock at the onset should have increased the PI due to vasodilation rather than decreasing it.…”

mentioning

confidence: 87%

“…Neonatal studies report low PI as a strong predictor of illness severity [8]. In the index study, children with shock had a significantly lower PI compared with those without shock [2].…”

mentioning

confidence: 91%

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Peripheral Perfusion Index – Magic Wand in Prediction of Shock?

Ismail

Sankar

2019

Indian J Pediatr

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Comparison of Predictive Ability of Macrocirculation and Microcirculation Markers on Outcomes of Patients with Septic Shock During Initial Fluid Resuscitation: A Prospective Observational Study

Shahsavarinia,

Sabzevari,

Shadvar

et al. 2024

Intensive Care Res

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Introduction This study aimed to compare the predictive abilities of macrocirculation markers (mean arterial pressure, heart rate, and central venous pressure), microcirculation markers (capillary refill time and peripheral perfusion index), as well as fluid balance, lactate level, and lactate clearance on the outcomes of patients with septic shock during initial resuscitation. Methods In this prospective, single-center observational study, adult patients with septic shock admitted to the intensive care unit (ICU) at Shohada Hospital in Tabriz, Iran, between December 2020 and September 2021, were included. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to assess the associations between macrocirculation markers (heart rate, mean arterial pressure, central venous pressure, and fluid balance) and microcirculation markers (capillary refill time, peripheral perfusion index, mottling score, lactate level, and lactate clearance level) with outcomes such as ICU length of stay, need for renal replacement therapy (RRT), vasopressor requirements, duration of mechanical ventilation (MV), and mortality rate. Assessments were performed at baseline, 6 h, and 24 h after fluid resuscitation. Results A total of 100 patients with septic shock (55 men and 45 women) were enrolled in the study. The area under the curve (AUC) values for the macrocirculation and microcirculation markers in predicting mortality ranged from 0.517 to 0.770 and 0.695 to 0.993, respectively. Among the macrocirculation markers, central venous pressure and mean arterial pressure at baseline showed the best predictive values for mortality, with AUCs of 0.770 and 0.753, respectively. Conclusion In patients with septic shock, microcirculation markers, particularly the peripheral perfusion index (PPI), demonstrated better predictive accuracy for mortality compared to macrocirculation markers. Furthermore, the combination of markers had a higher AUC, sensitivity, and specificity for predicting outcomes compared to individual markers alone.

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Prediction of Shock by Peripheral Perfusion Index

Cited by 23 publications

References 10 publications

Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

Peripheral Perfusion Index – Magic Wand in Prediction of Shock?

Comparison of Predictive Ability of Macrocirculation and Microcirculation Markers on Outcomes of Patients with Septic Shock During Initial Fluid Resuscitation: A Prospective Observational Study

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