Functional echocardiography as a tool for the dynamic treatment evaluation in critically ill neonates.

Abstract

It is still controversy about the usefulness of functional echocardiography (FnEC) in critically ill neonates. To analyze the usefulness of the FnEC in the treatment decisions in neonates admitted to a Neonatal Intensive Care Unit (NICU). A year prospective study in a NICU. A trained cardiologist performed a FnEC to 72 h of life patients to evaluate the cardiac function and heart structure. We analyzed the clinical decisions after the findings. 37 neonates underwent two FnEC: at the diagnosis and at follow-up. Eleven patients (29.7%) had structural and functional abnormalities, 9 (24.3%) only functional, 7 (18.9%) only structural, and in the rest, 10 (27%), were normal. Al least one change in the management occurred in 70% of the patients. The main changes were to the ventilatory support (63%), followed by inotropic support (19.5%) and fluid intake (10.8%). In all changes, we observed an improvement in the clinical conditions of the neonates. The FnEC allowed to determinate the cardiovascular structures and hemodynamic conditions of the patients and make a more precise therapeutic modifications.