226 - Perfusion In Preterm Infants (PIP) Study: A Continuous Non-Invasive Monitoring Of Perfusion In Very Low Birth Weight Preterm Infants

Poster Number: 226
Publication Number: 226.221

Nilesh Dankhara, University of Mississippi School of Medicine, Jackson, MS, United States; Jessie Smith, University of Mississippi School of Medicine, jackson, MS, United States; Jaimin M. Patel, University of Mississippi Medical Center, Jackson, MS, United States; Ashish M. Goti, NICE CHILDREN HOSPITAL, Surat, Gujarat, India; Divya Shakti, University of Mississippi School of Medicine, Jackson, MS, United States; Abhay Bhatt, University of Mississippi School of Medicine, Jackson, MS, United States; Jagdish Desai, University of Mississippi School of Medicine, Jackson, MS, United States

Background: There is no standard tool available to measure perfusion objectively, continuously and conveniently at the bedside in very low birth weight (VLBW) infants. The role of Perfusion Index (PI) as a tool to measure peripheral tissue perfusion and Near-Infrared Spectroscopy (NIRS, rcSO2) to monitor brain perfusion in VLBW infants is still being studied. We aimed to study the correlation between PI, rcSO2, mean blood pressure (MBP) and serum lactate during the first 96 hours of life in VLBW infants.

Objective: We aimed to study the correlation between PI, rcSO2, mean blood pressure (MBP) and serum lactate during the first 96 hours of life in VLBW infants.

Design/Methods: This was a prospective observational study. Infants born at ≤ 32 weeks of gestation or birth weight of 1500 gram born at our center except for critical congenital heart disease were enrolled within 24 hours of birth. PI and NIRS values were stored continuously in intervals of 30 seconds. MBPs were recorded every 3 hours, and serum lactates were collected at 6, 12, 24, 48, 72, and 96 hours of life. An average of 30 minutes of PI and NIRS recording around the time of MBP and lactate measurement were extracted and a Pearson correlation coefficient was obtained for each relationship. It was further confirmed by the bootstrapping method by age in hours. A linear regression model was conducted to control for age in hours, Gestational age (GA), ventilator status, COVERS score, and PDA status

Results: A total of 34 infants and 537 observations were included in the analysis. Mean(SD) gestation and birthweight were 28±2.6 and 1066±330 grams respectively. PI was positively correlated with rcSO2 (r=0.33, p=0.02) and negatively with serum lactate (r=0.-0.40, p=0.00). rcSO2 was negatively correlated with serum lactate (r= -0.37, p=0.00). MBP did not correlate statistically with serum lactate, PI and rcSO2 (Table 1, Figure 1).Conclusion(s): PI and rcSO2 can be used to monitor perfusion objectively, continuously and conveniently at the bedside. A positive correlation of PI and rcSO2 could guide us in designing futures studies to evaluate the relationship between peripheral perfusion and cerebral perfusion trends in hemodynamically unstable infants.
Correlation Coefficient of Perfusion Variables*p < 0.05
#Correlation coefficients using bootstrapping by age stratification
Correlation Coefficient of Perfusion Variables