Functional Neonatal Echocardiography: Indian Experience

Khamkar, Anilkumar M; Suryawanshi, Pradeep; Maheshwari, Rajesh; Patnaik, Suprabha; Malshe, Nandini; Kalrao, Vijay; Lalwani, Sanjay; Surwade, Jitendra

doi:10.7860/jcdr/2015/14440.6971

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…In other studies, it has been assessed with successive measurements. In the study by Khakmar et al 7 , patients had an average of two assessments, and in the study by Corredera et al up to an average of three 3 . Therefore, the usefulness of an initial assessment should also be considered in the future, where the structural aspect will be paramount, as well as repeated functional studies tailored to the requirements of each patient.…”

Section: Discussionmentioning

confidence: 93%

“…Two aspects our study contributes with are: -On the one hand, the decision to carry out FnECHO assessments as a usual procedure in every critically ill newborn, conversely to observations in the previous studies 3,7 , where the FnECHO indication has been especially in case of doubts in the diagnosis and treatment of patent ductus arteriosus, or in neonates with hemodynamic instability 10,12 . This difference may well explain the largest number of management modifications in our study (70%) in comparison with those reported in other studies, which range from 30 to 51% 7 . In our study, assessment is intended for both structural and functional diagnostic purposes.…”

Section: Discussionmentioning

confidence: 99%

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

Acevedo-Olguín¹,

Hernández-Benítez²,

Iglesias-Leboreiro³

et al. 2020

ACME

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Introduction: There is still controversy about the usefulness of functional echocardiography (FnEC) in critically ill neonates. Objective: The objective of the study was to analyze the usefulness of the FnEC in the treatment decisions in neonates admitted to a Neonatal Intensive Care Unit (NICU). Materials and methods: This was a 1-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. Results: Thirty-seven neonates underwent two FnEC: at the diagnosis and at follow-up. Eleven patients (29.7%) had structural and functional abnormalities, nine (24.3%) only functional, seven (18.9%) only structural, and in the rest, ten (27%) were normal. 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. Conclusions: The FnEC allowed to determinate the cardiovascular structures and hemodynamic conditions of the patients and make more precise therapeutic modifications.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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

Acevedo-Olguín¹,

Hernández-Benítez²,

Iglesias-Leboreiro³

et al. 2020

ACME

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“…This is comparable to the study done by Khamkar AM et al which showed that more preterm (60.43%) and low birth weight (75.4%) neonates undergo echocardiographic assessment. 12 Similarly study by Groves et al revealed that majority of the neonatal undergoing FnEcho were preterm and low birth weight. 9 In the present study, the most frequently diagnosed functional problem was persistent pulmonary hypertension (PPHN), hemodynamically significant Patent Ductus Arteriosus (hsPDA), Systemic Hypotension and Hypoxic Ischemic Cardiomyopathy.…”

Section: Discussionmentioning

confidence: 90%

Functional Echocardiography (FNECHO): Experience in NICU of A Tertiary Care Hospital

Subhani¹,

Hassan²,

Ayub³

et al. 2022

Ann Pak Inst Med Sci

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Objective: To describe the observational findings of functional echocardiography (FnEcho) in neonatal intensive care unit of a tertiary care hospital by evaluating its frequency of use, characteristics of patients and distribution of heart diseases. Methodology: This Prospective descriptive observational study was done in a tertiary neonatal intensive care unit (NICU) in Rawalpindi, from July 2017 to June 2018. A total of two hundred and twelve neonates admitted to the NICU undergoing echocardiographic assessment were included in the study. Qualitative variables like gender, mode of delivery, and diagnostic findings were represented in terms of frequency and percentages. Quantitative data like age, birth weight and gestational age were highlighted as mean and standard deviation. Results: Out of a total of 212 neonates, 111 (52.4%) were male. The mode of delivery was noted to be lower segment cesarean section among 126 (60.0%) neonates. The mean gestational age was found to be 36.47+2.3 weeks, ranging from 28 to 41 weeks, whereas the mean birth weight was 2.56+0.68 kg, ranging from 1.1 to 4.2 kg. A total of 75 neonates were found to have functional heart disease in the form of pulmonary hypertension 37 (17.4%), hemodynamically significant patent ductus arteriosus 24(11.3%), hypoxic ischemic cardiomyopathy 4(1.9%), and systemic hypotension 10 (17.4%). Conclusion: FnEcho was found to be an effective tool for identifying different kinds of functional and structural heart defects. VSD was found to be the most common type of congenital heart disease, followed by PDA. Timely intervention in PPHN was also rewarding with good outcome.

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“…En el 70% de ellos directamente aportó datos para cambios al tratamiento y en el 30% restante confirmó la adecuación del manejo ya establecido. Dos aspectos que aporta nuestro estudio son: -Por un lado la decisión de la realización de las EcoFn como un procedimiento habitual en todo neonato críticamente enfermo, contrario a lo observado en estudios previos 3,7 , donde la indicación de la EcoFn ha sido sobre todo ante dudas en el diagnóstico y tratamiento del conducto arterioso, o en neonatos con inestabilidad hemodinámica 10,12 . Esta diferencia bien puede explicar el mayor número de modificaciones al manejo en nuestro estudio (70%) frente a las informadas, del 30 al 51% 7 .…”

Section: Discussionunclassified

“…En otros estudios lo han evaluado con mediciones sucesivas. En el estudio de Khakmar, et al 7 en promedio a los pacientes se les realizaron dos valoraciones y en el estudio de Corredera, et al hasta un promedio de tres 3 . Por ello, igualmente a futuro se debe considerar la utilidad de una valoración inicial, donde el aspecto estructural será primordial y estudios repetidos funcionales a medida del requerimiento de cada pacientes.…”

Section: Discussionunclassified

Ecocardiografía funcional como una herramienta de evaluación dinámica del tratamiento en neonatos críticamente enfermos

Acevedo-Olguín¹,

Hernández-Benítez²,

Iglesias-Leboreiro

et al. 2020

ACM

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Material y métodos: Estudio prospectivo en una UCIN durante un año mediante EcoFn realizada por un cardiólogo capacitado en pacientes en sus primeras 72 horas de vida extrauterina, con valoración de la funcionalidad cardiaca y presencia de alteraciones estructurales. Con base en los hallazgos se analizaron las modificaciones al tratamiento. resultados: 37 neonatos fueron evaluados con EcoFn en dos ocasiones: una diagnóstica y otra de seguimiento. En 11 (29.7%) se encontró daño estructural y funcional, en 9 (24.3%) solo funcional, en 7 (18.9%) solo estructural y en 10 (27%) no se observaron alteraciones. En el 70% se realizó al menos un cambio de tratamiento. Los cambios más frecuentes fueron modificaciones al apoyo ventilatorio (63%), seguido del apoyo aminérgico (19.5%) y modificaciones en el aporte de líquidos (10.8%). En todos los casos los cambios mejoraron las condiciones clínicas de los neonatos. conclusiones: La EcoFn permitió determinar mejor las condiciones estructurales y hemodinámicas de los pacientes y realizar modificaciones terapéuticas más precisas.

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Functional Neonatal Echocardiography: Indian Experience

Cited by 10 publications

References 27 publications

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

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

Functional Echocardiography (FNECHO): Experience in NICU of A Tertiary Care Hospital

Ecocardiografía funcional como una herramienta de evaluación dinámica del tratamiento en neonatos críticamente enfermos

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