外周灌注指数在危重患者中的应用

doi:10.16352/j.issn.1001-6325.2025.02.0239

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (2): 239-243.doi: 10.16352/j.issn.1001-6325.2025.02.0239

外周灌注指数在危重患者中的应用

崔玉健, 李宇珂, 李双玲, 李楠^*

北京大学第一医院重症医学科,北京 100034

收稿日期:2024-10-11 修回日期:2024-12-03 出版日期:2025-02-05 发布日期:2025-01-17
通讯作者: ^*iculinan@163.com

Application of peripheral perfusion index in critically ill patients

CUI Yujian, LI Yuke, LI Shuangling, LI Nan^*

Department of Critical Care Medicine, Peking University First Hospital, Beijing 100034, China

Received:2024-10-11 Revised:2024-12-03 Online:2025-02-05 Published:2025-01-17
Contact: ^*iculinan@163.com

摘要/Abstract

摘要： 外周灌注指数(PPI)通过局部搏动血流与非搏动血流之比反映末梢微循环情况,是一个客观可靠的外周微循环指标。PPI在早期识别低血压、指导容量管理、评估血管张力、协助机械通气设置、早期识别术后并发症及判断危重患者不良预后等方面具有广泛的应用。

关键词: 外周灌注指数, 重症监护病房, 危重患者

Abstract: Peripheral perfusion index (PPI) is an Objective and reliable parameter reflecting the peripheral microcirculation through the ratio of local pulsatile to non-pulsatile blood flow. PPI is widely used in the early identification of hypotension, guiding volume management, assessing vascular tone, assisting mechanical ventilation settings, early identification of postoperative complications and poor prognosis of critically ill patients.

Key words: peripheral perfusion index, intensive care unit, critically ill patients

中图分类号:

R459.7

崔玉健, 李宇珂, 李双玲, 李楠. 外周灌注指数在危重患者中的应用[J]. 基础医学与临床, 2025, 45(2): 239-243.

CUI Yujian, LI Yuke, LI Shuangling, LI Nan. Application of peripheral perfusion index in critically ill patients[J]. Basic & Clinical Medicine, 2025, 45(2): 239-243.

参考文献 25

[1]	Sun X, He H, Xu M, et al. Peripheral perfusion index of pulse oximetry in adult patients: a narrative review[J]. Eur J Biomed Res, 2024, 29: 457. doi: 10.1186/s40001-024-02048-3.
[2]	Lima AP, Beelen P, Bakker J. Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion[J]. Crit Care Med, 2002, 30: 1210-1213. doi: 10.1097/00003246-200206000-00006.
[3]	van Genderen ME, Bartels SA, Lima A, et al. Peripheral perfusion index as an early predictor for central hypovolemia in awake healthy volunteers[J]. Anesth Analg, 2013, 116: 351-356. doi: 10.1213/ANE.0b013e318274e151.
[4]	石远峰, 殷睿宏, 王言理, 等. PPI在脓毒性休克早期诊断及治疗中的意义:一项前瞻性单盲随机对照试验[J]. 中华危重病急救医学, 2017, 29: 1065-1070.
[5]	Klijn E, Groeneveld AB, van Genderen ME, et al. Peripheral perfusion index predicts hypotension during fluid withdrawal by continuous veno-venous hemofiltration in critically ill patients[J]. Blood Purif, 2015, 40: 92-98. doi: 10.1159/000381939.
[6]	Beurton A, Teboul JL, Gavelli F, et al. The effects of passive leg raising may be detected by the plethysmo-graphic oxygen saturation signal in critically ill patients[J]. Crit Care, 2019, 23: 19. doi: 10.1186/s13054-019-2306-z.
[7]	Liu T, Xu C, Wang M, et al. Reliability of pleth variability index in predicting preload responsiveness of mechanically ventilated patients under various conditions: a systematic review and meta-analysis[J]. BMC Anesthesiol, 2019, 19: 67. doi: 10.1186/s12871-019-0744-4.
[8]	Beurton A, Gavelli F, Teboul JL, et al. Changes in the plethysmographic perfusion index during an end-expiratory occlusion detect a positive passive leg raising test[J]. Crit Care Med, 2021, 49: e151-e160. doi: 10.1097/ccm.0000000000004768.
[9]	de Courson H, Michard F, Chavignier C, et al. Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres?[J]. J Clin Monit Comput, 2020, 34: 1193-1198. doi: 10.1007/s10877-019-00445-2.
[10]	Hasanin A, Karam N, Mukhtar AM, et al. The ability of pulse oximetry-derived peripheral perfusion index to detect fluid responsiveness in patients with septic shock[J]. J Anesth, 2021, 35: 254-261. doi: 10.1007/s00540-021-02908-w.
[11]	van Genderen ME, Engels N, van der Valk RJ, et al. Early peripheral perfusion-guided fluid therapy in patients with septic shock[J]. Am J Respir Crit Care Med, 2015, 191: 477-480. doi: 10.1164/rccm.201408-1575LE.
[12]	He H, Long Y, Liu D, et al. Clinical classification of tissue perfusion based on the central venous oxygen saturation and the peripheral perfusion index[J]. Crit Care, 2015, 19: 330. doi: 10.1186/s13054-015-1057-8
[13]	Hasanin A, Mohamed SAR, El-Adawy A. Evaluation of perfusion index as a tool for pain assessment in critically ill patients[J]. J Clin Monit Comput, 2017, 31: 961-965. doi: 10.1007/s10877-016-9936-3.
[14]	Abdelhakeem AK, Amin A, Hasanin A, et al. Validity of pulse oximetry-derived peripheral perfusion index in pain assessment in critically ill intubated patients[J]. Clin J Pain, 2021, 37: 904-907. doi: 10.1097/ajp.0000000000000982.
[15]	Coutrot M, Dudoignon E, Joachim J, et al. Perfusion index: physical principles, physiological meanings and clinical implications in anaesthesia and critical care[J]. Anaesth Crit Care Pain Med, 2021, 40: 100964. doi: 10.1016/j.accpm.2021.100964.
[16]	Bai X, Yu W, Ji W, et al. Early versus delayed administration of norepinephrine in patients with septic shock[J]. Crit Care, 2014, 18: 532. doi: 10.1186/s13054-014-0532-y.
[17]	He HW, Liu WL, Zhou X, et al. Effect of mean arterial pressure change by norepinephrine on peripheral perfusion index in septic shock patients after early resuscitation[J]. Chin Med J (Engl), 2020, 133: 2146-2152. doi: 10.1097/cm9.0000000000001017.
[18]	Su L, Zhang R, Zhang Q, et al. The effect of mechanical ventilation on peripheral perfusion index and its association with the prognosis of critically ill patients [J]. Crit Care Med, 2019, 47: 685-690. doi: 10.1097/ccm.0000000000003661.
[19]	Lotfy A, Hasanin A, Rashad M, et al. Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation[J]. J Clin Monit Comput, 2021, 35: 405-412. doi: 10.1007/s10877-020-00483-1.
[20]	van Genderen ME, Paauwe J, de Jonge J, et al. Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults[J]. Crit Care, 2014, 18: R114. doi: 10.1186/cc13905.
[21]	Agerskov M, Thusholdt ANW, Holm-Sørensen H, et al. Association of the intraoperative peripheral perfusion index with postoperative morbidity and mortality in acute surgical patients: a retrospective observational multicentre cohort study[J]. Br J Anaesth, 2021, 127: 396-404. doi: 10.1016/j.bja.2021.06.004.
[22]	Krone S, Bokoch MP, Kothari R, et al. Association between peripheral perfusion index and postoperative acute kidney injury in major noncardiac surgery patients receiving continuous vasopressors: a post hoc exploratory analysis of the VEGA-1 trial[J]. Br J Anaesth, 2024, 132: 685-694. doi: 10.1016/j.bja.2023.11.054.
[23]	He HW, Liu DW, Long Y, et al. The peripheral perfusion index and transcutaneous oxygen challenge test are predictive of mortality in septic patients after resuscitation[J]. Crit Care, 2013, 17: R116. doi: 10.1186/cc12788.
[24]	Savastano S, Baldi E, Contri E, et al. Post-ROSC peripheral perfusion index discriminates 30-day survival after out-of-hospital cardiac arrest[J]. Intern Emerg Med, 2021, 16: 455-462. doi: 10.1007/s11739-020-02430-z.
[25]	Shi X, Xu M, Yu X, et al. Peripheral perfusion index predicting prolonged ICU stay earlier and better than lactate in surgical patients: an observational study[J]. BMC Anesthesiol, 2020, 20: 153. doi: 10.1186/s12871-020-01072-0.

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外周灌注指数在危重患者中的应用

Application of peripheral perfusion index in critically ill patients

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