Does Perfusion Index in Term Neonate with Late-Onset Pneumonia Predict Disease Severity and Prognosis? Geç Başlangıçlı Pnömonili Yenidoğanlarda Perfüzyon İndeksi Hastalığın Şiddeti ve Prognozu Öngörebilir mi?

Objective: Pneumonia is an important disease that causes sepsis in newborns and constitutes the majority of deaths due to infections, especially in developing countries. Pulse oximeters that are widely used in clinics, can determine heart rate, arterial oxygen saturation, additionally perfusion index (PI). In this study, the role of PI in determining the severity and prognosis of the disease in newborns with late-onset pneumonia (LOP); the relationship between PI and respiratory support need and Silverman Anderson Retraction Score (SAS) were aimed to determine. Material and Methods: In this prospective study, 30 term newborns diagnosed with late-onset pneumonia (LOP) were at the time of hospitalization,at the 24th hours of their treatment, and discharge; in the control group, PI measurements were made from the right upper extremity every 10 seconds for 3 minutes at the discharge of 30 term healthy newborns between December 2017 and June 2018. By comparing the data, it was aimed to determine the relationship of PI with the severity of the disease, prognosis, need for respiratory support and Silverman Anderson Retraction Score (SAS). Results: Their mean birth weights was 2000 4600 g the mean was 3570 g in the study, 2800 4100 g the mean was 3610 g in the control group and there was no significant difference (p>0.05); Gestational ages were 365/7 – 413/7, mean 392/7 in the study group, 373/7 – 405/7 in the control group, mean 396/7 weeks, and the statistical difference between the groups was not significant (p>0.05). The ratio of female/male was similar in the groups. Their median age was 9.5 days (3-27) in the control, 21 days (5-28) in the study group, and higher in the study group (p<0.05). The median capillary refill time was 1.7 seconds in the control, 1.6 seconds in the study group, and similar between the groups. The mean PI was 2.3±0.9 in the control group. In the study group, it was 3.6±1.2 on hospitalization, 3.2±1.2 on the first day, 3.4±0.7 at discharge. In the study group, PI values on hospitalization and first day were higher (p<0.05). There were reticular infiltration 50% bilateral, 30% right paracardiac, 10% left paracardiac, 3.3% right lower lobe. Alpha hemolytic streptococci in 1 (3.3%), Acinetobacter iwoffii in 1 (3.3%), Respiratory syncytial virus 6 (20%), Coronavirus 4 (13.3%), Rhinovirus 2 (6.7%) and Influenza A 1 (3.3%) patient were determined. We applied free flow oxygen 17 (56.7%), oxygen by hood 5 (16.7%), heated humidified high-flow nasal cannula 1 (3.3%), nasal continuous airway pressure 4 (13.3%), nasal intermittent positive pressure ventilation 4 (13.3%) cases. PI was higher in the patients needing positive pressure on admission (p<0.05). A positive correlation was found between SAS and PI on admission in the study group (p=0.008). The number of patients whose PI decreased during hospitalization increased over time. Conclusion: In the neonates with LOP, the severity of the disease, the need for respiratory support and prognosis cannot be predicted by PI. There was no relation between SAS and PI. Received / Geliş tarihi : 24.10.2021 Accepted / Kabul tarihi : 27.12.2021 Online published : 28.02.2022 Elektronik yayın tarihi DOI: 10.12956/tchd.1014166 1 Conflict of Interest / Çıkar Çatışması: On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethics Committee Approval / Etik Kurul Onayı: This study was conducted in accordance with the Helsinki Declaration Principles. The approval of the local ethics committee of Health Sciences University Ankara Pediatrics Hematology Oncology Training and Research Hospital dated 19/03/2018 and numbered 2017/131. Contribution of the Authors / Yazarların katkısı: GUNES K: Constructing the hypothesis or idea of research and/or article, Planning methodology to reach the Conclusions, Organizing, supervising the course of progress and taking the responsibility of the research/study, Taking responsibility in patient follow-up, collection of relevant biological materials, data management and reporting, execution of the experiments, Taking responsibility in logical interpretation and conclusion of the results, Taking responsibility in necessary literature review for the study, Taking responsibility in the writing of the whole or important parts of the study. UNAL S: Organizing, supervising the course of progress and taking the responsibility of the research/study, Reviewing the article before submission scientifically besides spelling and grammar. YAZICI A: Taking responsibility in patient follow-up, collection of relevant biological materials, data management and reporting, execution of the experiments. SIYAH BILGIN B: Planning methodology to reach the Conclusions, Taking responsibility in necessary literature review for the study. How to cite / Atıf yazım şekli : Gunes K, Unal S, Yazici A and Siyah Bilgin B. Does Perfusion Index in Term Neonate with Late-Onset Pneumonia Predict Disease Severity and Prognosis . Turkish J Pediatr Dis 202X; 0000-0002-2057-3565: GUNES K 0000-0001-7978-5848: UNAL S 0000-0001-9387-0029: YAZICI A 0000-0003-3807-4809: SIYAH BILGIN B Turkish Journal of Pediatric Disease Türkiye Çocuk Hastalıkları Dergisi