Functional echocardiography in neonatal intensive care: 1-Year experience in a unit in Spain

Abstract

Introduction: Several publications highlight the usefulness of functional echocardiography (FnECHO) in neonatal intensive care. Data are lacking on its use in neonatal units 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 haemodynamic 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 haemodynamic support. Echocardiographic evaluation included: assessment of presence/haemodynamic 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 haemodynamic instability are the most frequent indications. It still needs to be elucidated if the use of FnECHO modifies patient outcomes. © 2013 Asociacion Espa˜