J Pediatr Infect Dis 2018; 13(03): 247-251
DOI: 10.1055/s-0038-1649340
Rapid Communication
Georg Thieme Verlag KG Stuttgart · New York

Perfusion Index: A Noninvasive Tool for Clinical Decision in Neonates with Suspected Sepsis?

Alessandro Perri
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
,
Giovanni Barone
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
,
Rossella Iannotta
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
,
Anthea Bottoni
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
,
Eloisa Tiberi
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
,
Enrico Zecca
1  Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy
› Author Affiliations
Further Information

Publication History

23 November 2017

01 April 2018

Publication Date:
03 May 2018 (eFirst)

Abstract

Aim This article aims to assess whether perfusion index is significantly different in infants with positive C-reactive protein and/or positive cultures compared with a control group.

Methods This was a prospective observational cohort study. Perfusion index was evaluated in 80 neonates at the start of antibiotic therapy for suspected sepsis. Antibiotic therapy was started based on the antenatal history or the presence of clinical signs of sepsis such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, and metabolic acidosis. A case group of 23 neonates with abnormal C- reactive protein (> 10 mg/L) and/or positive cultures (blood, liquor, or bronchoalveolar lavage cultures) was compared with a control group of 23 neonates.

Results Cases (mean gestational age [GA], 33 ± 5) and controls (mean GA, 33 ± 5) were matched according to the following criteria: GA (±2 weeks), postmenstrual age (±2 weeks), early (< 72 hours), or late (> 72 hours) onset of suspected infection. Mean perfusion index was 0.8 ± 0.3 in the case group and 1.2 ± 0.4 in the control group; p-value of < 0.001.

Conclusions Perfusion index can be considered a noninvasive, reproducible, and easy-to-apply tool for early diagnosis of a neonatal acute inflammation in course of sepsis.