Abstract
Although the last two decades have seen major advances in the care of sick, extremely premature newborns, the approach to cardiovascular assessment and monitoring remains suboptimal owing to an overreliance on poorly predictive clinical markers such as heart rate or capillary refill time. Point-of-care functional echocardiography (PCFecho) enables real-time evaluation of cardiac performance and systemic hemodynamics to characterize acute physiology, identify the exact nature of cardiovascular compromise and guide therapeutic decisions. In this article, we will review four clinical scenarios where bedside functional cardiac imaging enabled delineation of the real clinical problem and refinement of the therapeutic care plan with direct patient benefits.
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References
Kluckow M, Seri I, Evans N . Functional echocardiography: an emerging clinical tool for the neonatologist. J Pediatr 2007; 150: 125–130.
Evans N, Kluckow M . Early determinants of right and left ventricular output in ventilated preterm infants. Arch Dis Child Fetal Neonatal Ed 1996; 74: F88–F94.
Kluckow M, Evans N . Superior vena cava flow in preterm infants: a novel marker of systemic blood flow. Arch Dis Child Fetal Neonatal Ed 2000; 82: 182–187.
Zhang J, Penny DJ, Kim NS, Yu VYH, Smolich J . Mechanisms of blood pressure increase induced by dopamine in hypotensive preterm neonates. Arch Dis Child Fetal Neonatal Ed 1999; 81: 99–104.
Finan E, Shivananda SP, Teixeira L, Mak W, McNamara PJ . Paediatric Academic Societies Annual Meeting 2007; Abstract no. 5896.3.
Skinner JR . Echocardiography on the neonatal unit: a job for the neonatologist or the cardiologist? Arch Dis Child 1998; 78: 401–402.
Evans N . Echocardiography on neonatal intensive care units in Australia and New Zealand. J Paediatr Child Health 2000; 36: 169–171.
Teixiera L, Shivananda S, Arsdell GV, James A, McNamara P . PDA ligation causes postoperative myocardial dysfunction in premature infants. Paediatric Academic Societies Annual Meeting 2006. Abstract no. 2863.238.
Sehgal A, McNamara P . Coronary artery perfusion is associated with impaired diastolic dysfunction in preterm infants after PDA ligation. Paediatric Academic Societies Annual Meeting 2007. Abstract no. 5896.15.
Moss S, Kitchener DJ, Yoxall CW, Subhedar NV . Evaluation of echocardiography on the neonatal unit. Arch Dis Child Fetal Neonatal Ed 2003; 88: F287–F291.
Ward CJ, Purdie J . Diagnostic accuracy of paediatric echocardiograms interpreted by individuals other than paediatric cardiologists. J Paediatr Child Health 2001; 37: 3316.
Kuschel CA, Evans N, Askie L, Bredemeyer S, Nash J, Polverino J . A randomized trial of enteral feeding volumes in infants born before 30 weeks' gestation. J Paediatr Child Health 2000; 36: 581–586.
Manasia AR, Nagaraj HM, Kodali RB, Croft RB, Oropello JM, Kohli-Seth R et al. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 2005; 19: 155–159.
Croft LB, Duvall WL, Goldman ME . A pilot study of the clinical impact of hand-carried cardiac ultrasound in the medical clinic. Echocardiography 2006; 23: 439–446.
Melamed R, Hanovich S, Shapiro R, Sprenkle M, Ulstad V, Leatherman J . Limited bedside echocardiography performed by intensivists in the medical intensive care unit. Chest 2005; 128 (Suppl): 207–208.
Alexander JH, Peterson ED, Chen AY, Harding TM, Adams DB, Kisslo Jr JA . Feasibility of point-of-care echocardiography by internal medicine house staff. Am Heart J 2004; 147: 476–481.
Thomas JD, Adams DB, DeVries S, Ehler D, Greenberg N, Garcia M et al. Guidelines and recommendations for digital echocardiography: a report from the digital echocardiography committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2005; 18: 287–297.
Jones AE, Craddock PA, Tayal VS, Kline JA . Diagnostic accuracy of left ventricular function for identifying sepsis among emergency department patients with nontraumatic symptomatic undifferentiated hypotension. Shock 2005; 24: 513–517.
Breitkreutz R, Walcher F, Seeger FH . Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm. Crit Care Med 2007; 35 (5 Suppl): S150–S161.
Sehgal A, Cook V, Dunn M . Pericardial effusion in association with an appropriately placed umbilical venous catheter. J Perinatol 2007; 27: 317–318.
Sehgal A, Skidmore M . Superior vena cava syndrome in a newborn: importance of point of care echocardiography. J Perinatol 2007; 27: 317–319.
Kluckow M, Evans N . Low superior vena cava flow and intraventricular haemorrhage in preterm infants. Arch Dis Child Fetal Neonatal Ed 2000; 82: F188–F194.
O'Rourke D, Khuffash A, Walsh K, Molloy E . Serial echocardiography in preterm infants may improve outcome. Acta Paediatr 2008; 97: 574–578.
Wren C . Commentary on Moss et al.'s ‘Evaluation of echocardiography on the neonatal unit’. Arch Dis Child Fetal Neonatal Ed 2003; 88: F290–F291.
Skinner J . Diagnosis of patent ductus arteriosus. Semin Neonatol 2001; 6: 49–61.
Katumba-Lunyenya JL . Neonatal/infant echocardiography by the non-cardiologist: a personal practice, past, present, and future. Arch Dis Child Fetal Neonatal Ed 2002; 86: F55–F57.
Samson GR, Kumar S . A study of congenital cardiac disease in a neonatal population; the validity of echocardiography undertaken by a neonatologist. Cardiol Young 2004; 14: 585–593.
Whitehall J . Echocardiography by a neonatologist. Arch Dis Child 1999; 80: 580–581.
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Sehgal, A., McNamara, P. Does point-of-care functional echocardiography enhance cardiovascular care in the NICU?. J Perinatol 28, 729–735 (2008). https://doi.org/10.1038/jp.2008.100
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DOI: https://doi.org/10.1038/jp.2008.100
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