Perfusion Index: Physical Principles, Physiological Meanings and Clinical Implications in Anaesthesia and Critical Care
Résumé
Photoplethysmography (PPG) has been extensively used for pulse oximetry monitoring in
anaesthesia, perioperative and intensive care. However, some components of PPG signal
have been employed for other purposes, such as non-invasive haemodynamic monitoring.
Perfusion index (PI) is derived from PPG signal and represents the ratio of pulsatile on non-
pulsatile light absorbance or reflectance of the PPG signal. PI determinants are complex and
interlinked, involving and reflecting the interaction between peripheral and central
haemodynamic characteristics, such as vascular tone and stroke volume. Recently, several
studies have shed light on the interesting performances of this variable, especially assessing
regional or neuraxial block success, and haemodynamic monitoring in anaesthesia,
perioperative and intensive care. Nevertheless, no review has yet been published concerning
the interest of PI in these fields.
In this narrative review will be exposed first the physiological and pathophysiological
determinants of PI, and then the mean to measure this value as well as its potential
limitations. In the second part, the existing data concerning usefulness of PI in different
clinical settings such as operating theatres, intensive care units and emergency departments
will be presented and discussed. Finally, the perspectives concerning the use of PI and
mentioned aspects that should be explored regarding this tool will be underlined.
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