A Corredera1, M J Rodríguez1, P Arévalo1, B Llorente1, M Moro1, L Arruza2. 1. Servicio de Neonatología, Hospital Clínico San Carlos, Madrid, España. 2. Servicio de Neonatología, Hospital Clínico San Carlos, Madrid, España. Electronic address: luisarruza@yahoo.es.
Abstract
INTRODUCTION: Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data is lacking on its use in units neonatal in Spain. OBJECTIVES: To evaluate frequency of use, patient characteristics, indications, measurements, and impact on patient management of FnECHO in a neonatal intensive care unit (NICU) in Spain over a 1 year period. METHODS: A retrospective study conducted in NICU patients during 1 year. VARIABLES: gestational age, birthweight, admission criteria, days of life at examination, indication for FnECHO, parameters assessed, and treatment modifications. RESULTS: 168 echocardiographic studies were performed in 50 patients (mean 3,4. SD 2,83). The most frequent indication was patent ductus (PDA) assessment (58.3%), followed by hemodynamic instability (22.2%). The results of FnECHO modified treatment in 62 cases (36.9%). In 17.4% of them treatment with ibuprofen was initiated, and in 1.2% it was discontinued. In 10.8% of the cases, the results of FnECHO modified hemodynamic support. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA (100%); myocardiac function: ejection fraction/shortening fraction (EF/SF) 23.8%, left ventricular output 24.4%, right ventricular output 21.4%, systemic blood flow 42.3%; and signs of pulmonary hypertension 7.7%. CONCLUSIONS: FnECHO is frequently used in the NICU, and in many cases it guides treatment. PDA assessment and hemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes.
INTRODUCTION: Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data is lacking on its use in units neonatal in Spain. OBJECTIVES: To evaluate frequency of use, patient characteristics, indications, measurements, and impact on patient management of FnECHO in a neonatal intensive care unit (NICU) in Spain over a 1 year period. METHODS: A retrospective study conducted in NICU patients during 1 year. VARIABLES: gestational age, birthweight, admission criteria, days of life at examination, indication for FnECHO, parameters assessed, and treatment modifications. RESULTS: 168 echocardiographic studies were performed in 50 patients (mean 3,4. SD 2,83). The most frequent indication was patent ductus (PDA) assessment (58.3%), followed by hemodynamic instability (22.2%). The results of FnECHO modified treatment in 62 cases (36.9%). In 17.4% of them treatment with ibuprofen was initiated, and in 1.2% it was discontinued. In 10.8% of the cases, the results of FnECHO modified hemodynamic support. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA (100%); myocardiac function: ejection fraction/shortening fraction (EF/SF) 23.8%, left ventricular output 24.4%, right ventricular output 21.4%, systemic blood flow 42.3%; and signs of pulmonary hypertension 7.7%. CONCLUSIONS: FnECHO is frequently used in the NICU, and in many cases it guides treatment. PDA assessment and hemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes.
Keywords:
Cuidados intensivos neonatales; Ecocardiografía funcional; Functional echocardiography; Intensive care unit; Newborn; Point-of-care ultrasound; Recién nacido; ecografía en el punto de la asistencia
Authors: Marina Maccagnano Zamith; Simone de Araujo Negreiros Figueira; Allan Chiaratti de Oliveira; Cristiane Metolina; Junia Sampel de Castro; Cristina Nunes Dos Santos; Ana Leticia de Oliveira Abrahão de Capo; Valdir Ambrósio Moisés Journal: J Pediatr (Rio J) Date: 2019-06-06 Impact factor: 2.990