Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: Practice Guidelines and Recommendations for Training: Writing group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC)

Abstract

AAP : American Academy of Pediatrics AEPC : Association for European Paediatric Cardiology ASE : American Society of Echocardiography CDH : Congenital diaphragmatic hernia CHD : Congenital heart disease EAE : European Association of Echocardiography ECMO : Extracorporeal membrane oxygenation EF : Ejection fraction LV : Left ventricular MPI : Myocardial performance index mVCFc : Mean velocity of circumferential fiber shortening NICU : Neonatal intensive care unit PA : Pulmonary artery PDA : Patent ductus arteriosus RA : Right atrial RV : Right ventricular RVSp : Right ventricular systolic pressure SF : Shortening fraction SVC : Superior vena cava TEE : Transesophageal echocardiography TNE : Targeted neonatal echocardiography TVI : Time-velocity integral 2D : Two-dimensional VLBW : Very low birth weight The role of echocardiography in the neonatal intensive care unit (NICU) has changed over the past few years. Previously, nearly all echocardiographic studies in the NICU were performed by pediatric cardiologists to diagnose or monitor congenital heart disease (CHD) and to screen for patent ductus arteriosus (PDA). More recently, neonatologists have become interested in the echocardiographic assessment of hemodynamic instability in infants. The terms functional echocardiography and point-of-care echocardiography have been introduced to describe the use of echocardiography as an adjunct in the clinical assessment of the hemodynamic status in neonates.1–4 The increasing availability of echocardiography, with miniaturization of the technology, has resulted in more widespread use of echocardiography in NICUs around the world.5 Perhaps the most significant challenge for the application of so-called functional studies is that newborns in the NICU with hemodynamic instability are at a much higher risk for having underlying CHD. In addition, newborns in the NICU are unique in that they are in the process of …