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The Ability of Pulse Oximetry-Derived Peripheral Perfusion Index as a New Predictor of Fluid Responsiveness in Critically Ill Patients.

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Title: The Ability of Pulse Oximetry-Derived Peripheral Perfusion Index as a New Predictor of Fluid Responsiveness in Critically Ill Patients.
Authors: Taha, Ahmed Aly1 ahmedalytaha95@gmail.com, Goudah, Tarek Elsayed1, Abdelmageed, Afaf Abdelhafez1, Bahram, Rehab Shaheen1
Source: Egyptian Journal of Hospital Medicine. Jul2025, Issue 100, p4407-4414. 8p.
Subject Terms: *PULSE oximetry, *CRITICALLY ill patient care, *PERFUSION, *ECHOCARDIOGRAPHY, *SENSITIVITY & specificity (Statistics)
Abstract (English): Background: Prediction of fluid responsiveness (FR) is of utmost significance in management of critically-ill patients. Echocardiography is a bedside, feasible tool in assessment of FR. Based on passive leg raising test (PLR), pulse oximetry-derived peripheral perfusion index (PPI) can be utilized in prediction of FR in critical-ill cases. Aim: This study aimed to investigate the ability of pulse oximetry-derived PPI as a new predictor of FR in critically-ill patients. Methods: This study included 95 critically-ill patients, after PLR test, 36 of our patients were found to be fluid responsive and 59 patients were fluid non-responsive. FR was defined by increase in ≥ 10% increase in left ventricular outflow tract (LVOT) velocity time integral (VTI) (LVOT-VTI) after PLR test. Bedsides, echocardiography and pulse co-oximetry were used to measure LVOT-VTI and PPI before and after both PLR and 200 mL fluid challenge with Ringer's solution in responders. Sequential Organ Failure Assessment (SOFA) score was calculated. Results: VTI and PPI increased after PLR test compared to baseline values. ΔPPI showed moderate ability to detect fluid responder [A cutoff value of 0.28 achieved a sensitivity (Sn) of 75.0% and specificity (Sp) of 72.9%, with a positive predictive value (PPV) of 63.4%, a negative predictive value (NPV) of 81.5%, and an accuracy of 73.7%. A significant relationship was recorded between ΔPPI and ΔVTI caused by the fluid challenge. Conclusion: Using bedside transthoracic echocardiography, PPI maneuver was a feasible, sensitive and highly specific method for prediction of fluid-responsiveness in critically-ill patients. [ABSTRACT FROM AUTHOR]
Abstract (Arabic): المقال يركز على تقييم فعالية مؤشر تدفق الأطراف المستمد من قياس التأكسج النبضي (PPI) كمتنبئ للاستجابة للسوائل (FR) لدى المرضى في حالة حرجة. أُجري البحث في جامعة المنصورة في مصر، وشمل 95 مريضًا، حيث تم تقييم الاستجابة للسوائل باستخدام اختبار رفع الساق السلبية وتصوير القلب بالموجات فوق الصوتية. أظهرت النتائج أن التغيرات في PPI بعد الاختبار يمكن أن تميز بشكل موثوق بين المستجيبين للسوائل وغير المستجيبين، مع حساسية تبلغ 75% وخصوصية تبلغ 72.9%. تشير النتائج إلى أن PPI قد يكون أداة عملية وغير جراحية لتقييم الاستجابة للسوائل في بيئات الرعاية الحرجة. [Extracted from the article]
Database: Academic Search Index
Description
Abstract:Background: Prediction of fluid responsiveness (FR) is of utmost significance in management of critically-ill patients. Echocardiography is a bedside, feasible tool in assessment of FR. Based on passive leg raising test (PLR), pulse oximetry-derived peripheral perfusion index (PPI) can be utilized in prediction of FR in critical-ill cases. Aim: This study aimed to investigate the ability of pulse oximetry-derived PPI as a new predictor of FR in critically-ill patients. Methods: This study included 95 critically-ill patients, after PLR test, 36 of our patients were found to be fluid responsive and 59 patients were fluid non-responsive. FR was defined by increase in ≥ 10% increase in left ventricular outflow tract (LVOT) velocity time integral (VTI) (LVOT-VTI) after PLR test. Bedsides, echocardiography and pulse co-oximetry were used to measure LVOT-VTI and PPI before and after both PLR and 200 mL fluid challenge with Ringer's solution in responders. Sequential Organ Failure Assessment (SOFA) score was calculated. Results: VTI and PPI increased after PLR test compared to baseline values. ΔPPI showed moderate ability to detect fluid responder [A cutoff value of 0.28 achieved a sensitivity (Sn) of 75.0% and specificity (Sp) of 72.9%, with a positive predictive value (PPV) of 63.4%, a negative predictive value (NPV) of 81.5%, and an accuracy of 73.7%. A significant relationship was recorded between ΔPPI and ΔVTI caused by the fluid challenge. Conclusion: Using bedside transthoracic echocardiography, PPI maneuver was a feasible, sensitive and highly specific method for prediction of fluid-responsiveness in critically-ill patients. [ABSTRACT FROM AUTHOR]
ISSN:16872002
DOI:10.21608/ejhm.2025.454570