DOI: https://doi.org/10.22141/2224-0586.1.88.2018.124974

Quantitative changes of the perfusion index in various pathological conditions

S.V. Kursov, V.V. Nikonov, O.V. Biletskiy, K.I. Lizogub

Abstract


The article presents the results of the study on peripheral capillary blood flow by photoplethysmometric determination of the value of the perfusion index (PI) in more than 600 patients in shock and other conditions associated with severe stress. It was found that the PI value decreased for all types of shock, regardless of their origin. It was shown that for compensated hypovolemic shock, the characteristic value of PI is 0.5–1.5 %, whereas in case of PI decompensation, it reaches no more than 0.5 %. The value of PI in cardiogenic shock was significantly lower. In most cases, it did not exceed 0.5 %. In various types of distributive shock, with no peripheral spasm of arterioles, however, there is a significant discrepancy between the normal volume of circulating intravascular fluid and dilated vascular bed, PI reaches 3.0 %. Thus, the value of PI can act as an additional diagnostic tool for detecting a leading hemodynamic mechanism for reducing cardiac output in shock conditions. Blood loss, which was not accompanied by the development of shock, was characterized by fluctuations in PI in the range of 1.75–3.0 %, preoperative psycho-emotional stress — 2.5–4.0 %, and surgical stress — in the range of 2.0–3.5 %, depending on the injury of surgical intervention and the quality of anesthesia. PI monitoring at various critical states, as well as in the context of planned and urgent surgical interventions, provides additional information on the dynamics of the seve­rity of the patient’s condition and the feasibility of the chosen correction.

Keywords


hemodynamics; shock; stress; peripheral capillary perfusion; photoplethysmometry; perfusion index

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