Pulmonary hypertension in a neonatologist-performed echocardiographic follow-up of bronchopulmonary dysplasia

Savoia, Marilena; Morassutti, Francesca Rech; Castriotta, Luigi; Pavoni, Daisy; Mourani, Peter M.; Freschi, Paola; Cattarossi, Luigi; Tonutti, Antonio

doi:10.1007/s00431-021-03954-y

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…Savoia et al published a report on a cohort of 23 preterm newborns where CLD follow-up took the form of echocardiography performed by neonatologists during intensive care and in an outpatient clinic. Excellent inter-rater agreement with the cardiology department was found ( 19 ). Our hospital started a TnECHO program in 2017, in which CLD assessment represents the fourth leading cause of hemodynamic consultation ( 20 ).…”

Section: Discussionmentioning

confidence: 95%

Targeted neonatal echocardiography and lung ultrasound in preterm infants with chronic lung disease with and without pulmonary hypertension, screened using a standardized algorithm

et al. 2023

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IntroductionIncreased recognition of the development of chronic pulmonary hypertension (cPH) in preterm infants with chronic lung disease (CLD) has prompted enhanced monitoring for the identification of different phenotypes.MethodsAll newborns consulted for oxygen/respiratory support dependency (CLD assessment) from January 2018 to December 2021 were included. TnECHO and LUS screening for cPH-CLD were performed at 36 weeks postmenstrual age. Cases of cPH related to increased pulmonary blood flow (cPH-IPBF) were referred to Pediatric Cardiology. The objective of the study was to identify all cases of cPH (cPH-CLD/IPBF) in the CLD patients screened and to compare outcomes. Following a standardized algorithm, cPH-CLD patients were treated with diuretics; ultrasounds taken before and after treatment were analyzed.ResultsSeventy-two patients with CLD were screened. Twenty-two (30%) had cPH-CLD, and nine (12%) had cPH-IPBF. cPH infants underwent more days of mechanical ventilation, were more likely to have retinopathy of prematurity, and showed increased mortality. The LUS pattern observed in the 72 CLD patients consisted of a thickened pleural line and a B-line interstitial heterogeneous pattern; 29% of patients were found to have lung consolidations. After diuretic therapy, step-down in respiratory support occurred in 59% of neonates with cPH-CLD. A decrease in respiratory rate (RR), right ventricular output (RVO), markers of pulmonary vascular resistance (PVR), and B-line pattern was observed. In tissue Doppler imaging, biventricular diastolic function was found to be modified after diuretics.ConclusionsCLD infants with cPH showed increased morbidity and mortality. In cPH-CLD patients, a decrease in RR and step-down in respiratory support was observed after diuretic treatment. Follow-up ultrasound showed a decrease in RVO, markers of PVR, and B-lines.

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Section: Discussionmentioning

confidence: 95%

Targeted neonatal echocardiography and lung ultrasound in preterm infants with chronic lung disease with and without pulmonary hypertension, screened using a standardized algorithm

et al. 2023

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“…Therefore, a thoughtful and structured sonographic workflow in sick neonates is required. Few studies have proposed a sonographic workflow in sick neonates,1 9 24 36 but mainly focused on echocardiography (Targeted neonatal Echocardiography, TnECHO) or lung ultrasound rather than comprehensive sonographic assessment 37–42. The comprehensive sonographic characteristics in critically ill neonates remain uncertain 9 24 43 44…”

Section: Introductionmentioning

confidence: 99%

A study protocol for investigating the sonographic characteristics of neonates with critical illness: an observational cohort study

Xiao

et al. 2023

bmjpo

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BackgroundHaemodynamic instability and hypoxaemia are common and serious threats to the survival of neonates. A growing body of literature indicates that critical care ultrasound has become the optimal evaluation tool for sick neonates. However, few studies have described sonographic characteristics of haemodynamics systematically in the neonates with critical illness. This protocol describes a prospective observational cohort study aimed at (1) characterising the sonographic characteristics of the neonates with critical diseases; and (2) assessing the mortality, significant morbidity, utility of vasoactive medications, fluid resuscitation, duration of ventilation, etc.Methods and analysisThis is a single-centre, prospective and observational study conducted in Chengdu Women’s and Children’s Central Hospital from 1 December 2022 to 31 December 2027. Neonates admitted to the neonatal intensive care unit will be recruited. After inclusion, the neonates will undergo the neonatal critical care ultrasound. The data collected via case report forms include clinical variables and sonographic measures. The primary outcome is to identify the sonographic characteristics of sick neonates with different diseases, and the secondary outcome is to describe the mortality, significant morbidity, utility of vasoactive medications, fluid resuscitation and duration of ventilation.DiscussionOur study provided an organised neonatal critical care ultrasound workflow, which can be applied in practice. Accordingly, this study will first set up large data on the sonographic description of the neonates with critical illness, which can help to understand the pathophysiology of the critical illness, potentially titrating the treatment.Trial registration numberChinese Clinical Trial Registry (ChiCTR2200065581;https://www.chictr.org.cn/com/25/showproj.aspx?proj=184095).

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“…NPE is an important tool for confirming the diagnosis and grading of PPHN, objective selection of specific therapies, and titrating and monitoring response to treatment. Specific protocols are available for assessing PH related to bronchopulmonary dysplasia [9,10], late onset sepsis [11], and congenital diaphragmatic hernia [12,13]. The aim of this article is to provide guidance to neonatologists undertaking fECHO examinations of newborn infants suspected of having PH to assist with diagnosis and management.…”

Section: Introductionmentioning

confidence: 99%

The role of bedside functional echocardiography in the assessment and management of pulmonary hypertension

Soni

Gupta

2022

Seminars in Fetal and Neonatal Medicine

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Pulmonary hypertension in a neonatologist-performed echocardiographic follow-up of bronchopulmonary dysplasia

Cited by 8 publications

References 40 publications

Targeted neonatal echocardiography and lung ultrasound in preterm infants with chronic lung disease with and without pulmonary hypertension, screened using a standardized algorithm

Targeted neonatal echocardiography and lung ultrasound in preterm infants with chronic lung disease with and without pulmonary hypertension, screened using a standardized algorithm

A study protocol for investigating the sonographic characteristics of neonates with critical illness: an observational cohort study

The role of bedside functional echocardiography in the assessment and management of pulmonary hypertension

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