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Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction

2007/09/10 by Anne de‐Wahl Granelli, Ingegerd Östman‐Smith · 1 citation
Medicine · #Congenital Heart Disease Studies #Cardiovascular Function and Risk Factors #Hemodynamic Monitoring and Therapy

paper · doi:10.1111/j.1651-2227.2007.00439.x

openalex publication_date 2007/09/10 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/23

Abstract

AIM: Peripheral perfusion index (PPI) has been suggested as a possible method to detect illness causing circulatory embarrassment. We aimed to establish the normal range of this index in healthy newborns, and compare it with newborns with duct-dependent systemic circulation. DESIGN: We conducted a case-control study. SETTING: Our study population comprised 10,000 prospectively recruited newborns from Västra Götaland, Sweden. PATIENTS: A total of 10,000 normal newborns and 9 infants with duct-dependent systemic circulation (left heart obstructive disease [LHOD] group) participated in the study. METHODS: We conducted single pre- and postductal measurements of PPI with a new generation pulse oximeter (Masimo Radical SET) before discharge from hospital. RESULTS: PPI values between 1 and 120 h of age show an asymmetrical, non-normal distribution with median PPI value of 1.70 and interquartile range of 1.18-2.50. The 5th percentile = 0.70 and 95th percentile = 4.50. All infants in the LHOD group had either pre- or postductal PPI below the interquartile range, and 5 of 9 (56%) were below the 5th percentile cut-off of 0.70 (p < 0.0001, Fisher's exact test). A PPI value <0.70 gave an odds ratio for LHOD of 23.75 (95% CI 6.36-88.74). CONCLUSION: PPI values lower than 0.70 may indicate illness and a value <0.50 (1st percentile) indicates definite underperfusion. PPI values might be a useful additional tool for early detection of LHOD.

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