Skip to main content
Top
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

Perfusion index assessment during transition period of newborns: an observational study

Authors: Sezin Unal, Ebru Ergenekon, Selma Aktas, Serdar Beken, Nilgun Altuntas, Ebru Kazanci, Ferit Kulali, Ibrahim M. Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay

Published in: BMC Pediatrics | Issue 1/2016

Login to get access

Abstract

Background

Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as “delayed transition”, others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them. We aimed to compare PI of neonates with TTN and delayed transition with controls, and assess its value on discrimination of delayed transition and TTN.

Methods

Neonates with gestational age between 37 and 40 weeks who were born with elective caesarian section were included. Eligible neonates were monitored with Masimo Set Radical7 pulse-oximeter (Masimo Corp., Irvine, CA, USA). Postductal PI, oxygen saturation and heart rate were manually recorded every 10 s for 3 min for two defined time periods as 10th minute and 1st hour. Axillary temperature were also recorded. Newborn infants were grouped as control, delayed transition, and TTN.

Results

Forty-nine tachypneic (TTN; 21, delayed transition; 28) and 30 healthy neonates completed the study. PI values were similar between three groups at both periods. There were no correlation between PI and respiratory rate, heart rate, and temperature.

Conclusion

PI assessment in maternity unit does not discriminate TTN from delayed transitional period in newborns which may indicate that peripheral perfusion is not severely affected in either condition.
Literature
2.
go back to reference Goldman JM, Petterson MT, Kopotic RJ, Barker SJ. Masimo signal extraction pulse oximetry. J Clin Monit Comput. 2000;16(7):475–83.CrossRefPubMed Goldman JM, Petterson MT, Kopotic RJ, Barker SJ. Masimo signal extraction pulse oximetry. J Clin Monit Comput. 2000;16(7):475–83.CrossRefPubMed
3.
go back to reference Kroese JK, van Vonderen JJ, Narayen IC, Walther FJ, Hooper S, Te Pas AB. The perfusion index of healthy term infants during transition at birth. Eur J Pediatr. 2016;175(4):475–9.CrossRefPubMed Kroese JK, van Vonderen JJ, Narayen IC, Walther FJ, Hooper S, Te Pas AB. The perfusion index of healthy term infants during transition at birth. Eur J Pediatr. 2016;175(4):475–9.CrossRefPubMed
4.
go back to reference Hawkes GA, O’Toole JM, Kenosi M, Ryan CA, Dempsey EM. Perfusion index in the preterm infant immediately after birth. Early Hum Dev. 2015;91(8):463–5.CrossRefPubMed Hawkes GA, O’Toole JM, Kenosi M, Ryan CA, Dempsey EM. Perfusion index in the preterm infant immediately after birth. Early Hum Dev. 2015;91(8):463–5.CrossRefPubMed
5.
go back to reference Kulali F, Ergenekon E, Aktas S, Kazanci E, Unal S, Hirfanoglu I, et al. Impact of mode of delivery on skin microcirculation in term healthy newborns within the first day of life. J Matern Fetal Neonatal Med. 2016;2016(1–5):1–5 [Epub ahead of print]. Kulali F, Ergenekon E, Aktas S, Kazanci E, Unal S, Hirfanoglu I, et al. Impact of mode of delivery on skin microcirculation in term healthy newborns within the first day of life. J Matern Fetal Neonatal Med. 2016;2016(1–5):1–5 [Epub ahead of print].
6.
go back to reference De Felice C, Del Vecchio A, Criscuolo M, Lozupone A, Parrini S, Latini G. Early postnatal changes in the perfusion index in term newborns with subclinical chorioamnionitis. Arch Dis Child Fetal Neonatal Ed. 2005;90(5):F411–4.CrossRefPubMedPubMedCentral De Felice C, Del Vecchio A, Criscuolo M, Lozupone A, Parrini S, Latini G. Early postnatal changes in the perfusion index in term newborns with subclinical chorioamnionitis. Arch Dis Child Fetal Neonatal Ed. 2005;90(5):F411–4.CrossRefPubMedPubMedCentral
7.
go back to reference Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol. 1995;102(2):101–6.CrossRefPubMed Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol. 1995;102(2):101–6.CrossRefPubMed
8.
go back to reference Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D. Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr. 2004;93(5):643–7.CrossRefPubMed Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D. Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr. 2004;93(5):643–7.CrossRefPubMed
9.
go back to reference Fedakar A, Aydogdu C. Clinical features of neonates treated in the intensive care unit for respiratory distress. Turk J Pediatr. 2011;53(2):173–9.PubMed Fedakar A, Aydogdu C. Clinical features of neonates treated in the intensive care unit for respiratory distress. Turk J Pediatr. 2011;53(2):173–9.PubMed
10.
go back to reference Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child. 1966;111(4):380–5.CrossRefPubMed Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child. 1966;111(4):380–5.CrossRefPubMed
11.
go back to reference Transient Tachypnea of Newborn. In Gomella TH, Cunningham M, Eyal FG, editors. Neonatology, Management, Procedures, On-Call Problems, Diseases, and Drugs. Mc Graw Hill Education; 2013. p. 919-25. Transient Tachypnea of Newborn. In Gomella TH, Cunningham M, Eyal FG, editors. Neonatology, Management, Procedures, On-Call Problems, Diseases, and Drugs. Mc Graw Hill Education; 2013. p. 919-25.
12.
go back to reference Isik DU, Bas AY, Demirel N, Kavurt S, Aydemir O, Kavurt AV, et al. Increased asymmetric dimethylarginine levels in severe transient tachypnea of the newborn. J Perinatol. 2016;36(6):459–62.CrossRefPubMed Isik DU, Bas AY, Demirel N, Kavurt S, Aydemir O, Kavurt AV, et al. Increased asymmetric dimethylarginine levels in severe transient tachypnea of the newborn. J Perinatol. 2016;36(6):459–62.CrossRefPubMed
13.
go back to reference Aydemir O, Aydemir C, Sarikabadayi YU, Altug N, Erdeve O, Uras N, et al. The role of plasma N-terminal pro-B-type natriuretic peptide in predicting the severity of transient tachypnea of the newborn. Early Hum Dev. 2012;88(5):315–9.CrossRefPubMed Aydemir O, Aydemir C, Sarikabadayi YU, Altug N, Erdeve O, Uras N, et al. The role of plasma N-terminal pro-B-type natriuretic peptide in predicting the severity of transient tachypnea of the newborn. Early Hum Dev. 2012;88(5):315–9.CrossRefPubMed
14.
go back to reference Teitel DF, Iwamoto HS, Rudolph AM. Effects of birth-related events on central blood flow patterns. Pediatr Res. 1987;22(5):557–66.CrossRefPubMed Teitel DF, Iwamoto HS, Rudolph AM. Effects of birth-related events on central blood flow patterns. Pediatr Res. 1987;22(5):557–66.CrossRefPubMed
15.
go back to reference Harrison W, Goodman D. Epidemiologic Trends in Neonatal Intensive Care, 2007–2012. JAMA Pediatr. 2015;169(9):855–62.CrossRefPubMed Harrison W, Goodman D. Epidemiologic Trends in Neonatal Intensive Care, 2007–2012. JAMA Pediatr. 2015;169(9):855–62.CrossRefPubMed
16.
go back to reference Hein HA, Ely JW, Lofgren MA. Neonatal respiratory distress in the community hospital: when to transport, when to keep. J Fam Pract. 1998;46(4):284–9.PubMed Hein HA, Ely JW, Lofgren MA. Neonatal respiratory distress in the community hospital: when to transport, when to keep. J Fam Pract. 1998;46(4):284–9.PubMed
17.
go back to reference ACOG Committee Opinion No 579: Definition of term pregnancy. Obstet Gynecol. 2013;122(5):1139–40 ACOG Committee Opinion No 579: Definition of term pregnancy. Obstet Gynecol. 2013;122(5):1139–40
18.
go back to reference Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Number 326, December 2005. Inappropriate use of the terms fetal distress and birth asphyxia. Obstet Gynecol. 2005;106(6):1469–70.CrossRef Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Number 326, December 2005. Inappropriate use of the terms fetal distress and birth asphyxia. Obstet Gynecol. 2005;106(6):1469–70.CrossRef
19.
go back to reference Ovali F. Intrauterine growth curves for Turkish infants born between 25 and 42 weeks of gestation. J Trop Pediatr. 2003;49(6):381–3.CrossRefPubMed Ovali F. Intrauterine growth curves for Turkish infants born between 25 and 42 weeks of gestation. J Trop Pediatr. 2003;49(6):381–3.CrossRefPubMed
20.
go back to reference De Felice C, Latini G, Vacca P, Kopotic RJ. The pulse oximeter perfusion index as a predictor for high illness severity in neonates. Eur J Pediatr. 2002;161(10):561–2.CrossRefPubMed De Felice C, Latini G, Vacca P, Kopotic RJ. The pulse oximeter perfusion index as a predictor for high illness severity in neonates. Eur J Pediatr. 2002;161(10):561–2.CrossRefPubMed
21.
go back to reference Granelli A, Ostman-Smith I. Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction. Acta Paediatr. 2007;96(10):1455–9.CrossRefPubMed Granelli A, Ostman-Smith I. Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstruction. Acta Paediatr. 2007;96(10):1455–9.CrossRefPubMed
22.
go back to reference van Vonderen JJ, Roest AA, Siew ML, Walther FJ, Hooper SB, te Pas AB. Measuring physiological changes during the transition to life after birth. Neonatology. 2014;105(3):230–42.CrossRefPubMed van Vonderen JJ, Roest AA, Siew ML, Walther FJ, Hooper SB, te Pas AB. Measuring physiological changes during the transition to life after birth. Neonatology. 2014;105(3):230–42.CrossRefPubMed
23.
go back to reference van Vonderen JJ, Roest AA, Siew ML, Blom NA, van Lith JM, Walther FJ, et al. Noninvasive measurements of hemodynamic transition directly after birth. Pediatr Res. 2014;75(3):448–52.CrossRefPubMed van Vonderen JJ, Roest AA, Siew ML, Blom NA, van Lith JM, Walther FJ, et al. Noninvasive measurements of hemodynamic transition directly after birth. Pediatr Res. 2014;75(3):448–52.CrossRefPubMed
24.
go back to reference van Vonderen JJ, te Pas AB, Kolster-Bijdevaate C, van Lith JM, Blom NA, Hooper SB, et al. Non-invasive measurements of ductus arteriosus flow directly after birth. Arch Dis Child Fetal Neonatal Ed. 2014;99(5):F408–12.CrossRefPubMed van Vonderen JJ, te Pas AB, Kolster-Bijdevaate C, van Lith JM, Blom NA, Hooper SB, et al. Non-invasive measurements of ductus arteriosus flow directly after birth. Arch Dis Child Fetal Neonatal Ed. 2014;99(5):F408–12.CrossRefPubMed
25.
go back to reference Hakan N, Dilli D, Zenciroglu A, Aydin M, Okumus N. Reference values of perfusion indices in hemodynamically stable newborns during the early neonatal period. Eur J Pediatr. 2014;173(5):597–602.CrossRefPubMed Hakan N, Dilli D, Zenciroglu A, Aydin M, Okumus N. Reference values of perfusion indices in hemodynamically stable newborns during the early neonatal period. Eur J Pediatr. 2014;173(5):597–602.CrossRefPubMed
26.
go back to reference Hummler HD, Engelmann A, Pohlandt F, Hogel J, Franz AR. Decreased accuracy of pulse oximetry measurements during low perfusion caused by sepsis: Is the perfusion index of any value? Intensive Care Med. 2006;32(9):1428–31.CrossRefPubMed Hummler HD, Engelmann A, Pohlandt F, Hogel J, Franz AR. Decreased accuracy of pulse oximetry measurements during low perfusion caused by sepsis: Is the perfusion index of any value? Intensive Care Med. 2006;32(9):1428–31.CrossRefPubMed
27.
go back to reference Costa S, Rocha G, Leitao A, Guimaraes H. Transient tachypnea of the newborn and congenital pneumonia: a comparative study. J Matern Fetal Neonatal Med. 2012;25(7):992–4.CrossRefPubMed Costa S, Rocha G, Leitao A, Guimaraes H. Transient tachypnea of the newborn and congenital pneumonia: a comparative study. J Matern Fetal Neonatal Med. 2012;25(7):992–4.CrossRefPubMed
Metadata
Title
Perfusion index assessment during transition period of newborns: an observational study
Authors
Sezin Unal
Ebru Ergenekon
Selma Aktas
Serdar Beken
Nilgun Altuntas
Ebru Kazanci
Ferit Kulali
Ibrahim M. Hirfanoglu
Esra Onal
Canan Turkyilmaz
Esin Koc
Yildiz Atalay
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0701-z

Other articles of this Issue 1/2016

BMC Pediatrics 1/2016 Go to the issue