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Photoplethysmographic assessment of pulse transit time correlates with echocardiographic measurement of stroke volume in preterm infants with patent ductus arteriosus

Journal of Perinatology volume 38, pages 1220–1226 (2018)Cite this article

Subjects

Abstract

Objective

We aimed to correlate photoplethysmographic parameters with stroke volume in infants with PDA. Photoplethysmography constitutes the optical signal in pulse oximetry.

Study design

Stroke volume was determined echocardiographically. Pulse transit time, right hand to foot arrival time difference, and relative amplitude were measured from pulse oximeter and ECG waveforms. Photoplethysmographic parameters before and after PDA closure were compared with stroke volume.

Results

After PDA closure, pulse transit time to the hand and to the foot were prolonged (54.7 ± 6.7 vs 65.5 ± 9.8 ms, p < 0.001, 82.5 ± 12.8 vs 88.6 ± 10.6 ms, p = 0.03), arrival time difference decreased (27.7 ± 7.6 vs 23.1 ± 5.6 ms, p = 0.021), and relative amplitude decreased (from 2.1 ± 0.7% to 1.5 ± 0.5%, p = 0.003). The time-based photoplethysmographic parameters correlated with stroke volume.

Conclusions

Photoplethysmographic waveform parameters are significantly different before and after PDA closure and the time-based parameters correlate well with stroke volume. Monitoring pulse transit time may assist in evaluation for spontaneous PDA closure or response to therapy.

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Author contributions

C.A. helped design the study, performed the data collection, analyzed the clinical and echocardiographic data of study patients with P.D.A, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted. L.P. performed the data collection, drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted. G.G. designed and performed the digital signal analysis, and approved the final manuscript as submitted. Y.A. designed and built the PPG device and the associated data acquisition system and approved the final manuscript as submitted. M.N. helped design the study, designed the technological aspects of the study, verified the signal analysis, helped in the interpretation of the results, critically reviewed the manuscript, and approved the final manuscript as submitted. A.B. helped design the study, critically reviewed the manuscript, and approved the final manuscript as submitted. D.M. performed the surgical ligations and reviewed and approved the final manuscript as submitted. E.K. analyzed the echocardiographic data of the study patients and approved the final manuscript as submitted. D.G. performed the data analysis, critically reviewed the manuscript, and approved the final manuscript as submitted. R.K. conceptualized and designed the study, supervised data collection, critically reviewed the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Cohen Children’s Medical Center of New York/Northwell Health, New Hyde Park, NY, USA

    Cynthia R. Amirtharaj, Lynn C. Palmeri, Dorota Gruber, Andrew Blaufox, David B. Meyer, Elena N. Kwon & Robert Koppel

  2. Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Cynthia R. Amirtharaj, Lynn C. Palmeri, Dorota Gruber, Andrew Blaufox, Elena N. Kwon & Robert Koppel

  3. Applied Physics/Electro-Optics, Lev Academic Center, Jerusalem, Israel

    Gideon Gradwohl, Yair Adar & Meir Nitzan

  4. Department of Cardiothoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    David B. Meyer

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  1. Cynthia R. Amirtharaj
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Correspondence to Robert Koppel.

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Amirtharaj, C.R., Palmeri, L.C., Gradwohl, G. et al. Photoplethysmographic assessment of pulse transit time correlates with echocardiographic measurement of stroke volume in preterm infants with patent ductus arteriosus. J Perinatol 38, 1220–1226 (2018). https://doi.org/10.1038/s41372-018-0165-0

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