Does targeted neonatal echocardiography affect hemodynamics and cerebral oxygenation in extremely preterm infants?
- 17 July 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Perinatology
- Vol. 34 (11), 847-849
- https://doi.org/10.1038/jp.2014.127
Abstract
Objective: To investigate the effect of targeted neonatal echocardiography (TnEcho) on heart rate, arterial oxygen saturation (SPO2), cerebral regional oxygen saturation (CrSO2) and cerebral fractional oxygen extraction (CFOE) in extremely preterm infants during the first 3 postnatal days. Study Design: As a nested study in a prospective observational study, we acquired continuous data on heart rate, SPO2, CrSO2 and CFOE. Data averaged for the duration of TnEcho study were compared with the data collected during a baseline period immediately before the start of echocardiography. The duration of the baseline and study periods was the same. TnEcho evaluation included assessment of preload, afterload, contractility, left and right ventricular output, patent ductus arteriosus and foramen ovale. Result: We analyzed 138 data pairs before and during TnEcho in 22 extremely preterm infants (gestational age 25.9±1.2 weeks; range 23 to 27). There was no significant difference in heart rate between baseline and TnEcho period. There was a statistical, but clinically negligible, difference between baseline and TnEcho in SPO2 (median (quartile) 91.4% (88.9, 94.2) vs 91.3% (88.9, 94), P=0.048), CrSO2 (76.8% (70.7, 81.5) vs 74.9% (69.5, 80.1), PP2, CrSO2 and CFOE, the alterations were minimal and unlikely of clinical relevance. Thus, cerebral hemodynamics and systemic and cerebral oxygenation are not perturbed during TnEcho and the procedure is well tolerated by the extremely preterm infants during the postnatal transitional period.Keywords
This publication has 10 references indexed in Scilit:
- Changes in Cardiac Function and Cerebral Blood Flow in Relation to Peri/Intraventricular Hemorrhage in Extremely Preterm InfantsThe Journal of Pediatrics, 2014
- Targeted neonatal echocardiography (TnECHO) service in a Canadian neonatal intensive care unit: a 4-year experienceJournal of Perinatology, 2013
- Targeted Neonatal Echocardiography in the Neonatal Intensive Care Unit: Practice Guidelines and Recommendations for TrainingJournal of the American Society of Echocardiography, 2011
- Clinical monitoring of systemic hemodynamics in critically ill newbornsEarly Human Development, 2010
- Changes in cerebral oxygenation and hemodynamics during cranial ultrasound in preterm infantsBrain & Development, 2009
- Cerebral Hemodynamic Changes During Intensive Care of Preterm InfantsPediatrics, 2008
- Monitoring Neonatal Regional Cerebral Oxygen Saturation in Clinical Practice: Value and PitfallsNeonatology, 2008
- Cardiorespiratory stability during echocardiography in preterm infantsArchives of Disease in Childhood, 2005
- Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhageThe Journal of Pediatrics, 1990
- Fluctuating Cerebral Blood-Flow Velocity in Respiratory-Distress SyndromeNew England Journal of Medicine, 1983