Marilena Savoia, Eva Busolini, Daniel Ibarra Rios, Brady Thomas, J. Lauren Ruoss, Patrick J. McNamara
S. Maria della Misericordia Hospital. Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. University of Iowa. Winnie Palmer Hospital/Orlando Health Regional Hospital.
Italy, Mexico and United States
Journal of Pediatrics
J Pediatr 2024;
DOI: 10.1016/j.jpeds.2024.114200
Introduction
The use of lung ultrasound (LU) and targeted neonatal echocardiography (TNE), performed by trained neonatologists as part of routine clinical care, has become a standard in some neonatal intensive care units (NICU) over the past decade although their use synergistically is rare. Cardiopulmonary monitoring is an integral component of neonatal intensive care; however, dynamic heart-lung interaction has been the subject of little scientific investigation. The importance of diagnostic precision and individualization of the care due to the dynamic nature of cardiopulmonary physiology lends additional credence to the importance of concurrent lung-hemodynamic evaluation. Guidelines for the use of TNE by neonatologists were first published by the American Society of Echocardiography (ASE) in 2011, and recently updated. Over the past decade similar guidelines have been published by other societies to provide governance and context specific to local regions. The hemodynamic consultation involves performing a comprehensive TNE assessment, using standardized imaging protocols, to generate physiologic data which are integrated within the clinical context to reach a diagnosis and provide management recommendations. Hemodynamic consultations are typically performed in patients with low risk of congenital heart disease to evaluate heart function, systemic and pulmonary hemodynamics, and the impact of transitional shunts. Recent publications have demonstrated the positive impact of TNE-guided care in the setting of pulmonary hypertension (PH), hemodynamic instability, and patent ductus arteriosus (PDA) closure. Giesinger et al demonstrated a reduction in severe intraventricular hemorrhage, necrotizing enterocolitis and severe bronchopulmonary dysplasia (BPD), when extremely preterm infants born less than 27 weeks gestational age (GA) underwent screening TNE between 12-18 hours after birth.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No