Usefulness of Perfusion Index for Detection of Lower LimbPeripheral Artery Disease in Hemodialysis Patients

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  • 血液透析患者の下肢末梢動脈疾患に対する灌流指標の有用性
  • ケツエキ トウセキ カンジャ ノ カシ マッショウ ドウミャク シッカン ニ タイスル カンリュウ シヒョウ ノ ユウヨウセイ

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 Measurement of the perfusion index (PI) , which is an additional function of the Masimo pulse oximeter Pront®, may be useful for the evaluation of lower limb hemodynamics. In this study, the PI of 91 patients was measured before and after dialysis, and receiver operating characteristic analysis was used to compare the test accuracy due to the difference in measurement time. The accuracy of the skin perfusion pressure（SPP）and toe brachial pressure index（TBI）for peripheral artery disease（PAD）was compared. The PI test accuracy was excellent in the latter half of dialysis, with a cutoff value of 2.57, sensitivity of 91.7%, and specificity of 69.4%. In comparison with each test, it was equivalent to the SPP and significantly superior to the TBI. The PI is measured in the same manner by a pulse oximeter; the measurements can be taken easily and quickly, requiring no specific skills. Therefore, the maximum advantages of this machine are observed during a foot check. In addition to physical observations, quantitative evaluation of the PI for each patient over time was suggested as a tool for the early detection of PAD in dialysis patients.

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