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  • Clinical Research Article
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Echocardiography performed by the neonatologist: the impact on the clinical management

Pediatric Research volume 94, pages 724–729 (2023)Cite this article

Abstract

Background

The aim of this study was to assess whether neonatologist-performed echocardiography (NPE) changed the previously planned hemodynamic approach in critically ill newborn infants.

Methods

This prospective cross-sectional study included the first NPE of 199 neonates. Before the exam, the clinical team was asked about the planned hemodynamic approach and the answer was classified as an intention to change or not to change the therapy. After being informed about the NPE results, the clinical management was grouped as performed as previously planned (maintained) or modified.

Results

NPE modified the planned pre-exam approach in 80 cases (40.2%; 95% CI: 33.3–47.4%), and variables associated with an increased chance of this modification were exams to assess pulmonary hemodynamics (prevalent ratio (PR): 1.75; 95% CI: 1.02–3.00) and to assess systemic flow (PR: 1.68; 95% CI: 1.06–2.68) in relation to those requested for patent ductus arteriosus, pre-exam intention of changing the prescribed management (PR: 2.16; 95% CI: 1.50–3.11), use of catecholamines (PR: 1.68; 95% CI: 1.24–2.28) and birthweight (per kg) (PR: 0.81; 95% CI: 0.68–0.98).

Conclusion

The NPE was an important tool to direct hemodynamic management in a different approach from the previous intention of the clinical team, mainly for critically ill neonates.

Impact

  • This study shows that neonatologist-performed echocardiography guides the therapeutic planning in the NICU, mainly in the more unstable newborns, with lower birthweight and receiving catecholamines.

  • Exams requested with the intention of modifying the current approach were more likely to change the management in a different way than planned pre-exam.

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Data availability

The complete database is available on request with the corresponding author.

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Author information

Authors and Affiliations

  1. Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina – Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Simone de Araujo Negreiros Figueira, Allan Chiaratti de Oliveira, Cristiane Metolina, Milton Harumi Miyoshi & Ruth Guinsburg

  2. Department of Internal Medicine, Escola Paulista de Medicina – Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Marina Maccagnano Zamith

  3. Department of Preventive Medicine, Escola Paulista de Medicina – Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Adriana Sanudo

Authors
  1. Simone de Araujo Negreiros Figueira
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  2. Allan Chiaratti de Oliveira
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  3. Marina Maccagnano Zamith
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  4. Cristiane Metolina
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  5. Milton Harumi Miyoshi
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  6. Adriana Sanudo
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  7. Ruth Guinsburg
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Contributions

S.d.A.N.F. has participated in the concept and design; collection of data; analysis and interpretation of data; drafting and revising the manuscript. A.S. has participated in design; statistical analysis and interpretation of data; drafting and revising the manuscript. A.C.d.O. and R.G. have participated in the concept and design; analysis and interpretation of data; drafting and revising the manuscript. M.M.Z., C.M. and M.H.M. participated in the design of the study, interpretation of data, and revising the manuscript.

Corresponding author

Correspondence to Simone de Araujo Negreiros Figueira.

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Competing interests

The authors declare no competing interests.

Ethics approval

The research protocol was approved by the Ethics Committee Universidade Federal de São Paulo – Unifesp (approval number 2,083,829).

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This manuscript is being submitted only to Pediatric Research and it will not be submitted elsewhere while under consideration. All authors listed on the manuscript approved the submission of this version of the manuscript and take full responsibility for the manuscript.

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Negreiros Figueira, S.d.A., de Oliveira, A.C., Zamith, M.M. et al. Echocardiography performed by the neonatologist: the impact on the clinical management. Pediatr Res 94, 724–729 (2023). https://doi.org/10.1038/s41390-023-02526-0

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