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

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Abstract

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.

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