Plethysmography variability index (PVI) changes in preterm neonates with shock-an observational study.
IVC collapsibility index
PVI
Shock
Volume status
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
25
03
2020
accepted:
17
07
2020
revised:
10
07
2020
pubmed:
14
8
2020
medline:
24
6
2021
entrez:
14
8
2020
Statut:
ppublish
Résumé
Shock is an acute state of circulatory dysfunction. The diagnosis of shock is complex in neonates. The relative sensitivity of current clinical or laboratory findings for detecting shock is largely unknown, especially for preterm neonates. For preload assessment, inferior vena cava (IVC) collapsibility can be a useful bedside echocardiography parameter. plethysmography variability index (PVI) is a marker of fluid responsive shock in adults and children, but not well defined in neonates. In this prospective observational study, we evaluated the changes in PVI in preterm neonates with shock. Among the 37 infants enrolled in the study, the mean blood pressure (MAP) was 45 (± 4 mm of Hg) and none of infants had hypotension. The mean pulse pressure was 28 mm of Hg, the mean PVI was 28% (±5), the mean arterial blood gas pH was 7.20 (±0.07), and the mean base deficit was 9.9 (±2.53) at the onset of shock. Thirty (96.77%) of the 31 infants with resolution of shock showed decrease in PVI with an average decrease of 11% (±5).Conclusion: Significant proportion of neonates show an increase in PVI at the onset of shock. What is Known: • Plethysmography Variability Index (PVI) is commonly used as a marker of volume status in paediatric population. • Changes in PVI may guide in giving volume boluses in patients with shock. What is New: • This study provides information of changes in PVI in preterm neonates with shock. • PVI may become a valuable tool to be used at bedside in preterm infants with shock.
Identifiants
pubmed: 32789541
doi: 10.1007/s00431-020-03749-7
pii: 10.1007/s00431-020-03749-7
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
379-385Références
Saini SS, Kumar P, Kumar RM (2014) Hemodynamic changes in preterm neonates with septic shock: a prospective observational study*. Pediatr Crit Care Med 15(5):443–50
doi: 10.1097/PCC.0000000000000115
Baske K, Saini SS, Dutta S, Sundaram V (2018) Epinephrine versus dopamine in neonatal septic shock: a double-blind randomized controlled trial. Eur J Pediatr 177(9):1335–1342
doi: 10.1007/s00431-018-3195-x
Szabó M, Bozó A, Darvas K, Horváth A, Iványi ZD (2019) Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study. BMC Anesthesiol 19:139. https://doi.org/10.1186/s12871-019-0809-4
doi: 10.1186/s12871-019-0809-4
pubmed: 31390983
pmcid: 6686491
Corl KA, George NR, Romanoff J, Levinson AT, Chheng DB, Merchant RC, Levy MM, Napoli AM (2017) Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients. J Crit Care 41:130–137. https://doi.org/10.1016/j.jcrc.2017.05.008
doi: 10.1016/j.jcrc.2017.05.008
pubmed: 28525778
Mugloo MM, Malik S, Akhtar R (2017) Echocardiographic inferior vena cava measurement as an alternative to central venous pressure measurement in neonates. Indian J Pediatr 84(10):751–756. https://doi.org/10.1007/s12098-017-2382-5
doi: 10.1007/s12098-017-2382-5
pubmed: 28634780
Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, Sanchez-de-Toledo J, Brierley J, Colunga JM, Raffaj D, da Cruz E, Durand P, Kenderessy P, Lang HJ, Nishisaki A, Kneyber MC, Tissieres P, Conlon TW, de Luca D (2020) International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS working Group of the European Society of Paediatric and neonatal intensive care (ESPNIC). Crit Care 24:65. https://doi.org/10.1186/s13054-020-2787-9
doi: 10.1186/s13054-020-2787-9
pubmed: 32093763
pmcid: 7041196
Kieliszczyk J, Baranowski W, Kosiak W (2016) Usefulness of ultrasound examination in the evaluation of a neonate’s body fluid status. J Ultrason 16(65):125–134
doi: 10.15557/JoU.2016.0014
Renner J, Broch O, Gruenewald M, Scheewe J, Francksen H, Jung O, Steinfath M, Bein B (2011) Non-invasive prediction of fluid responsiveness in infants using pleth variability index. Anaesthesia. 66(7):582–589
doi: 10.1111/j.1365-2044.2011.06715.x
den Boogert WJ, van Elteren HA, Goos TG, Reiss IKM, de Jonge RCJ, van den Berg VJ (2018) Reproducibility of the pleth variability index in premature infants. J Clin Monit Comput 32(3):457–464
doi: 10.1007/s10877-017-0058-3
Desai J, Patel E, Syeda O, Agarwal P, Paulos Y, Chawla S. Title: perfusion index (PI) and Pleth variability index (PVI): a noninvasive monitoring of hemodynamics in very low birth weight infants (VLBW). 2015
Goldstein B, Giroir B, Randolph A (2005) International consensus conference on pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 6(1):2–8
Seri I (2001) Neonatal shock: etiology, pathophysiology and management. Prenat Neonatal Med 6. https://doi.org/10.1080/13598630108500263
Deshpande SA, Platt MP (1997) Association between blood lactate and acid-base status and mortality in ventilated babies. Arch Dis Child Fetal Neonatal Ed 76(1):F15–F20. https://doi.org/10.1136/fn.76.1.f15
doi: 10.1136/fn.76.1.f15
pubmed: 9059180
pmcid: 1720617
Vidal M, Ferragu F, Durand S, Baleine J, Batista-Novais AR, Cambonie G (2013) Perfusion index and its dynamic changes in preterm neonates with patent ductus arteriosus. Acta Paediatr Oslo Nor 1992 102(4):373–378
Raja JA, S B, K M (2017) Perfusion index and plethysmographic variability index values in spontaneously breathing clinically stable term neonates in room air in the first 10 days of life. Pediatr Rev Int J Pediatr Res [Internet]. [cited 2019 Jun 18];4(08). Available from: http://medresearch.in/index.php/IJPR/article/view/1954
Latini G, Dipaola L, De Felice C (2012) First day of life reference values for pleth variability index in spontaneously breathing term newborns. Neonatology. 101(3):179–182
doi: 10.1159/000331774
Keller G, Cassar E, Desebbe O, Lehot JJ, Cannesson M (2008) Ability of pleth variability index to detect hemodynamic changes induced by passive leg raising in spontaneously breathing volunteers. Crit Care 12:R37. https://doi.org/10.1186/cc6822
doi: 10.1186/cc6822
pubmed: 18325089
pmcid: 2447559