1 Walter Reed National Military Medical Center, Department of Pediatrics, Division of Neonatology, Bethesda, USA.
2 Uniformed Services University of Health Sciences, Department of Pediatrics, Bethesda, USA.
J Telemed Telecare. 2018 Apr;24(3):224-229. doi: 10.1177/1357633X16689500. Epub 2017 Jan 17.
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.
介绍 远程超声心动图可确保及时诊断，并防止不必要地转运无严重先天性心脏病的婴儿，特别是在缺乏通往三级医疗中心的隔离地点。
方法 我们回顾性分析了 2005 年 6 月至 2014 年 3 月期间在一个偏远的 16 张床位的三级 B 新生儿重症监护病房进行远程超声心动图检查的所有婴儿。冲绳的心脏超声医师完成远程超声心动图检查，并将其异步传输给夏威夷的儿科心脏病专家进行审查。
结果 在研究期间，100 名婴儿接受了 192 次远程超声心动图检查：46%的婴儿因疑似动脉导管未闭而完成远程超声心动图检查，28%的婴儿因疑似先天性心脏病而完成远程超声心动图检查，12%的婴儿因可能患有肺动脉高压合并先天性心脏病而完成远程超声心动图检查，10%的婴儿因其他先天性异常合并可能患有先天性心脏病而完成远程超声心动图检查。其中，17 名患儿因心脏原因被空运转移；12 名患儿被转运到夏威夷，而 5 名患有复杂心脏病的患儿则直接转运到美国大陆，因为夏威夷没有介入心脏病治疗能力。
讨论 本研究表明，远程超声心动图可用于指导治疗，减少长途和潜在风险大的跨太平洋转运，并将转运至具有最合适心脏治疗能力的目的地中心进行分类。
