Assesment of Pleth Variablity Index in Moderate-late Preterm Infants

Abstract

Objective: The pleth variability index (PVI) allows the non-invasive detection of hemodynamic changes but is not yet commonly used in neonates. This study determined reference values for PVI in spontaneously breathing moderate to late preterm newborns during the first 12 hours of life and evaluate the relationship between these values and respiratory morbidity. Methods: The study included infants born at 32-37 weeks of gestation who had good spontaneous respiratory effort, were hemodynamically stable and were hospitalized in a tertiary neonatal intensive care unit. PVI, perfusion index (PI), oxygen saturation, and heart rate were prospectively monitored every 2 s for the first 12 h postnatally. Basic characteristic findings were obtained from patient records. Results: Data from a total of 58 patients were analyzed. The mean PVI was 21+-4.3% and mean PI was 0.85+-0.25%. Comparison of patients who required respiratory support (n=43) and those who received no respiratory support (n=15) showed that the heart rate (137.5+-10.6 vs. 129.7+-9.6, p=0.01) is significantly higher and PI (0.8+-0.2% vs. 0.9+-0.3%, p=0.03) is significantly lower in the respiratory support group. Moreover, PVI levels were found to be slightly higher in infants who get respiratory support (21.7+-4.5% vs. 19.2+-3.2%, p=0.05). Conclusion: PVI can be successfully measured in moderate-to late preterm newborns. More extensive studies are needed to obtain information on the clinical use of PVI, interpretation of abnormal results, its association with neonatal morbidities, and treatment management.

Keywords

• preterm
• pleth variability index
• pulse oximeter