Plethysmographic Peripheral Perfusion Index: Could It Be a New Vital Sign?

Mamdouh M Elshal; Ahmed M Hasanin; Maha Mostafa; Reham M Gamal

doi:10.3389/fmed.2021.651909

Plethysmographic Peripheral Perfusion Index: Could It Be a New Vital Sign?

Front Med (Lausanne). 2021 Oct 1:8:651909. doi: 10.3389/fmed.2021.651909. eCollection 2021.

Authors

Mamdouh M Elshal¹, Ahmed M Hasanin², Maha Mostafa², Reham M Gamal¹

Affiliations

¹ Department of Anesthesia and Critical Care Medicine, National Cancer Institute, Cairo University, Cairo, Egypt.
² Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.

Abstract

The plethysmographic peripheral perfusion index (PPI) is a very useful parameter with various emerging utilities in medical practice. The PPI represents the ratio between pulsatile and non-pulsatile portions in peripheral circulation and is mainly affected by two main determinants: cardiac output and balance between sympathetic and parasympathetic nervous systems. The PPI decreases in cases of sympathetic predominance and/or low cardiac output states; therefore, it is a useful predictor of patient outcomes in critical care units. The PPI could be a surrogate for cardiac output in tests for fluid responsiveness, as an objective measure of pain especially in un-cooperative patients, and as a predictor of successful weaning from mechanical ventilation. The PPI is simple to measure, easy to interpret, and has continuously displayed variables, making it a convenient parameter for detecting the adequacy of blood flow and sympathetic-parasympathetic balance.

Keywords: anesthesia; critically ill; peripheral perfusion index; plethysmography; shock.

Publication types

Review