Araştırma Makalesi
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Clinical Assessment of Perfusion Index in Patients Presenting to the Emergency Department with Non-ST-segment Elevation Myocardial Infarction and Unstable Angina Pectoris

Yıl 2022, Cilt: 19 Sayı: 1, 184 - 188, 28.04.2022
https://doi.org/10.35440/hutfd.1067974

Öz

Background: We aimed to evaluate the perfusion index (PI) level at the 10th minute of admission to the emergency department in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). In addition, we aimed to evaluate whether PI is useful in differentiating NSTEMI and USAP patients in the emergency department in the early stage.
Materials and Methods: Eighty NSTEMI (Group 1) and 50 USAP (Group 2) patients who were consecutively admitted to our emergency department between November 2017 and May 2019 and diagnosed with acute coronary syndrome were included in the study. In both patient groups, PI measured with the Massimo-SET Root 7362A RDS7 non-invasive pulse oximetry probe and other routine laboratory measurements were measured and compared.
Results: The mean PI was significantly lower in NSTEMI patients (p <0.001). At 30-day patient follow-up, the PI of the reduce was significantly lower (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016). At 30-day patient follow-up, the level of PI was significantly lower in the died patients than the survived patients (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016).
Conclusions: Although our study shows that PI may be an early marker in the distinguish of NSTEMI and USAP patients and may be useful in predicting the mortality of these patients, more extensive studies will support our hypothesis.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • 1. Karabulut D,Karabulut U, Erdal GS, Kasapoğlu P,Turhan N, Satılmışoğlu MH,et al. Biyobelirteçler, koroner arter hastalığının şiddetini gösterebilir mi? Cukurova Med J 2021;46(3):883-8.
  • 2. Nanas S, Gerovasili V, Renieris P, Angelopoulos E, Poriazi M, Kritikos K , et al. Non-invasive assessment of the microcirculation in critically ill patients. Anaesth Intensive Care, 2009;37(5):733-9.
  • 3. Benjamin E J, Virani SS, Callaway CW, Chamberlain AM, Chang AR,Cheng S. et al., Heart disease and stroke statistics-2018 update: a report from the American Heart Association, Circulation, 2018: 20;137(12):e67-e492.
  • 4. De Felice C, Latini G, Vacca P, Kopotic RJ. The pulse oximeter perfusion index as a predictor for high illness severity in neonates. Eur J Pediatr. 2002;161(10):561-2.
  • 5. Goldman JM, Petterson MT, Kopotic RJ, Barker SJ. Masimo signal extraction pulse oximetry. Journal of clinical monitoring and computing 2000;16(7):475-83.
  • 6.Chan D, Martin-Ruiz C, Saretzki G, Neely D, Qiu W, Kunadian V. The association of telomere length and telomerase activity with adverse outcomes in older patients with non-ST-elevation acute coronary syndrome. PLoS One 2020:10;15(1):e0227616.
  • 7. Wang L, Ji Y. Noncoding RNAs as Biomarkers for Acute Coronary Syndrome. BioMed Research International. Hindawi BioMed Research International 2020;3;1-11.
  • 8. Finsterer J, Stollberger C, Krugluger W. Cardiac and noncardiac, particularly neuromuscular, disease with troponin-T positivity. The Netherlands Journal of Medicine 2007:65(8);289-95.
  • 9. Røsjø H, Varpula M. Hagve TA, Karlsson S,Ruokonen E,Pettilä V et al. Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome.Intensive Care Med 2011:37(1):77-85.
  • 10. Enes Celik E, Kavak GO. Evaluation of Brachial Plexus Block With Plethysmographic Variability Index and Perfusion Index. Journal of Harran University Medical Faculty 2021;18(2):170-5.
  • 11. Galvin EM, Niehof S, Verbrugge SJ, et al. Peripheral flow index is a reliable and early indicator of regional block success. Anesth Analg 2006; 103:239–43.
  • 12. Hummler HD, Engelmann A, Pohlandt F, Högel J, Franz AR. Decreased accuracy of pulse oximetry measurements during low perfusion caused by sepsis: Is the perfusion index of any value? Intensive Care Med 2006; 32:1428–31.
  • 13. Louie A, Feiner JR, Bickler PE, Rhodes L, Bernstein M, Lucero J. Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion. Anesthesiology 2018; 128:520-30.
  • 14. De Backer D, Donadello K, Sakr Y, Ospina-Tascon G,Salgado D,Scolletta Set al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med 2013; 41:791–9.
  • 15. Okada H, Tanaka M, Yasuda T, Okada Y, Norikae H, Fujita T et al. Decreased microcirculatory function measured by perfusion index is predictive of cardiovascular death. Heart Vessels. Heart and Vessels 2020; 35 (7):930–5.
  • 16. Sürmeli M: Acil servise başvuran hastalarda hızlı ventrikül cevaplı atrial fibrilasyonun perfüzyon indeksi üzerine etkisi. Uzmanlık tezi: Sağlık Bilimleri Üniversitesi, İstanbul Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, İstanbul, 2015

Acil Servise ST Segment Elevasyonlu Olmayan Miyokard Enfarktüsü ve Kararsız Angina Pektoris ile Başvuran Hastalarda Perfüzyon İndeksinin Klinik Değerlendirmesi

Yıl 2022, Cilt: 19 Sayı: 1, 184 - 188, 28.04.2022
https://doi.org/10.35440/hutfd.1067974

Öz

Amaç: segmenti yükselmesi olmayan miyokard infarktüsü (NSTEMI) ve kararsız anjina pektoris (USAP) has-talarında, acil servise başvurularının 10. dakikasında perfüzyon indeksi (PI) düzeyini değerlendirmeyi amaçladık. Ayrıca, acil serviste NSTEMI ve USAP hastalarını erken safhada ayırt etmede PI’nın bir faydalı olup olmadığını değerlendirmeyi amaçladık.
Materyal ve Metod: Kasım 2017- Mayıs 2019 tarihleri arasında acil servisimize ardışık olarak başvuran, akut koroner sendromu tanısı alan 80 NSTEMI (Grup 1) ve 50 USAP hastası (Grup 2) çalışmaya dahil edildi. Her iki hasta grubunda, Massimo-SET Root 7362A RDS7 non invazif pulse oksimetri cihazı probu yardımı ile ölçülen PI ve diğer rutin laboratuvar ölçüldü ve karşılaştırma yapıldı.
Bulgular: NSTEMI hastalarında PI ortalaması belirgin olarak düşük idi (p<0.001). 30 günlük hasta takibinde, ölen hastalarda PI seviyesi hayatta kalan hastalara göre anlamlı olarak daha düşüktü (P <0.001). Eğri altın-daki alan, NSTEMI hastalarında PI için önemli ölçüde daha düşüktü (eğri altındaki alan 0.313, p = 0.016).
Sonuç: Çalışmamız, PI'nin NSTEMI ve USAP hastalarının ayırt edilmesinde erken bir belirteç olabileceğini ve bu hastaların mortalitesini tahmin etmede faydalı olabileceğini gösterse de daha kapsamlı çalışmalar hipo-tezimizi destekleyecektir.

Proje Numarası

NONE

Kaynakça

  • 1. Karabulut D,Karabulut U, Erdal GS, Kasapoğlu P,Turhan N, Satılmışoğlu MH,et al. Biyobelirteçler, koroner arter hastalığının şiddetini gösterebilir mi? Cukurova Med J 2021;46(3):883-8.
  • 2. Nanas S, Gerovasili V, Renieris P, Angelopoulos E, Poriazi M, Kritikos K , et al. Non-invasive assessment of the microcirculation in critically ill patients. Anaesth Intensive Care, 2009;37(5):733-9.
  • 3. Benjamin E J, Virani SS, Callaway CW, Chamberlain AM, Chang AR,Cheng S. et al., Heart disease and stroke statistics-2018 update: a report from the American Heart Association, Circulation, 2018: 20;137(12):e67-e492.
  • 4. De Felice C, Latini G, Vacca P, Kopotic RJ. The pulse oximeter perfusion index as a predictor for high illness severity in neonates. Eur J Pediatr. 2002;161(10):561-2.
  • 5. Goldman JM, Petterson MT, Kopotic RJ, Barker SJ. Masimo signal extraction pulse oximetry. Journal of clinical monitoring and computing 2000;16(7):475-83.
  • 6.Chan D, Martin-Ruiz C, Saretzki G, Neely D, Qiu W, Kunadian V. The association of telomere length and telomerase activity with adverse outcomes in older patients with non-ST-elevation acute coronary syndrome. PLoS One 2020:10;15(1):e0227616.
  • 7. Wang L, Ji Y. Noncoding RNAs as Biomarkers for Acute Coronary Syndrome. BioMed Research International. Hindawi BioMed Research International 2020;3;1-11.
  • 8. Finsterer J, Stollberger C, Krugluger W. Cardiac and noncardiac, particularly neuromuscular, disease with troponin-T positivity. The Netherlands Journal of Medicine 2007:65(8);289-95.
  • 9. Røsjø H, Varpula M. Hagve TA, Karlsson S,Ruokonen E,Pettilä V et al. Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome.Intensive Care Med 2011:37(1):77-85.
  • 10. Enes Celik E, Kavak GO. Evaluation of Brachial Plexus Block With Plethysmographic Variability Index and Perfusion Index. Journal of Harran University Medical Faculty 2021;18(2):170-5.
  • 11. Galvin EM, Niehof S, Verbrugge SJ, et al. Peripheral flow index is a reliable and early indicator of regional block success. Anesth Analg 2006; 103:239–43.
  • 12. Hummler HD, Engelmann A, Pohlandt F, Högel J, Franz AR. Decreased accuracy of pulse oximetry measurements during low perfusion caused by sepsis: Is the perfusion index of any value? Intensive Care Med 2006; 32:1428–31.
  • 13. Louie A, Feiner JR, Bickler PE, Rhodes L, Bernstein M, Lucero J. Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion. Anesthesiology 2018; 128:520-30.
  • 14. De Backer D, Donadello K, Sakr Y, Ospina-Tascon G,Salgado D,Scolletta Set al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med 2013; 41:791–9.
  • 15. Okada H, Tanaka M, Yasuda T, Okada Y, Norikae H, Fujita T et al. Decreased microcirculatory function measured by perfusion index is predictive of cardiovascular death. Heart Vessels. Heart and Vessels 2020; 35 (7):930–5.
  • 16. Sürmeli M: Acil servise başvuran hastalarda hızlı ventrikül cevaplı atrial fibrilasyonun perfüzyon indeksi üzerine etkisi. Uzmanlık tezi: Sağlık Bilimleri Üniversitesi, İstanbul Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, İstanbul, 2015
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Ömer Kaçmaz 0000-0001-8715-312X

Gül Şahika Gökdemir 0000-0002-8691-1504

Mehmet Ozel 0000-0002-4797-7017

Mehmet Tahir Gökdemir 0000-0002-5546-9653

Proje Numarası NONE
Yayımlanma Tarihi 28 Nisan 2022
Gönderilme Tarihi 3 Şubat 2022
Kabul Tarihi 24 Şubat 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 19 Sayı: 1

Kaynak Göster

Vancouver Kaçmaz Ö, Gökdemir GŞ, Ozel M, Gökdemir MT. Clinical Assessment of Perfusion Index in Patients Presenting to the Emergency Department with Non-ST-segment Elevation Myocardial Infarction and Unstable Angina Pectoris. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(1):184-8.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty