Targeted neonatal echocardiography (TnECHO) service in a Canadian neonatal intensive care unit: a 4-year experience

• Published in: Journal of perinatology Vol. 33; no. 9; pp. 687 - 690
• Main Authors: EL-Khuffash, A, Herbozo, C, Jain, A, Lapointe, A, McNamara, P J
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.09.2013; Nature Publishing Group
• Subjects: 692/700/1421/1860/1445; 692/700/1720; 692/700/228; Blood flow; Canada; Cardiology Service, Hospital - organization & administration; Catheters; Clinical decision making; Clinical medicine; Congenital diseases; Coronary vessels; Decision making; Ductus Arteriosus, Patent - diagnostic imaging; Ductus Arteriosus, Patent - therapy; Echocardiography; Evaluation; Female; Hemodynamics; Hospitals; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - diagnostic imaging; Infant, Premature, Diseases - therapy; Infants; Infants (Newborn); Intensive care; Intensive Care, Neonatal - organization & administration; Intervention; Male; Medical examination; Medical instruments; Medicine; Medicine & Public Health; Neonatal care; Neonates; Newborn babies; Observations; original-article; Pediatric intensive care; Pediatric Surgery; Pediatrics; Physiology; Referral and Consultation - organization & administration; Retrospective Studies; Canada; Toronto Ontario Canada; United States > US; intensive care; neonate; echocardiography
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2013.42

Objective: To characterize the effect of a targeted neonatal echocardiography (TnECHO) program on decision making in a tertiary level unit. Study design: Retrospective cohort study of neonates, admitted between September 2007 and April 2011. Details of the TnECHO, and the clinical decisions within 6 h of the consultation were recorded. Result: A total of 199 infants underwent 512 echocardiograms with a median (interquartile range) of 2 (1 to 3) TnECHO studies per infant. The indications included assessment for patent ductus arteriosus (PDA; n =261, 51%), post-PDA ligation assessment ( n =101, 19%), pulmonary hemodynamics ( n =81, 16%), myocardial performance and systemic blood flow ( n =52, 10%), and central venous catheter tip position ( n =6, 1%). TnECHO consultation was followed by a change in clinical management in 212 cases (41%) and avoidance of a planned intervention in 112 cases (22%). Conclusion: TnECHO may be a useful tool to guide clinical decisions in the neonatal intensive care unit setting. Well-planned prospective studies are needed to assess the impact of TnECHO on outcomes.