Evaluation of Perfusion Index as a Predictor of Neonatal Shock

A BSTRACT Aims: To determine the diagnostic accuracy of perfusion index (PI) in predicting neonatal shock, to characterize the temporal relationship between PI decline and the clinical onset of shock, and to examine the association of PI with major neonatal morbidities and mortality. Settings and Design: This 2-year, prospective, observational study, conducted at a tertiary neonatal intensive care unit in Central India with appropriate ethical clearance, consecutively enrolled neonates of all gestational ages having baseline PI ≥ 0.8, with serial two-hourly Masimo SET radical pulse oximeter recordings obtained until overt hemodynamic compromise became clinically evident. Subjects and Methods: This study was conducted across all gestational ages admitted to the unit. Receiver operating characteristic (ROC) analysis was employed to derive an optimal PI cutoff value. Statistical Analysis Used: Data were analyzed using the SPSS software version 21.0 (IBM, Chicago, IL, USA); normality was assessed by the Kolmogorov–Smirnov test, inter-group comparisons performed using the independent t -test or Mann–Whitney U -test and Chi-square test, and diagnostic accuracy of PI evaluated via ROC analysis.