Centre de Pediatrie, Clinique des Grangettes, 7 ch des Grangettes, 1224 Chêne-Bougeries, Geneva, Switzerland.
Department of Pediatric Cardiology and Neonatal Medicine, Cambridge University Hospitals.
Curr Opin Pediatr. 2020 Apr;32(2):235-244. doi: 10.1097/MOP.0000000000000887.
The role of echocardiography has dramatically changed over the past decade and use of functional echocardiography has become increasingly popular among neonatologists and pediatric intensivists in making clinical decisions in sick infants and children. The purpose of this review is to outline the current capabilities and limitations of functional echocardiography, best practices for its clinical application, and evidence for its utility.
Functional echocardiography can provide direct assessment of hemodynamics at bedside and can be used as a modern hemodynamic monitoring tool in the neonatal intensive care unit. It is now being regarded as a useful extension to the clinical examination and other monitoring tools in the critically ill infant. The anatomic, physiological, and hemodynamic information functional echocardiography provides can be used in targeting specific interventions and evaluating response to treatment.
This review article is focused on an overview of the most common applications of functional neonatal echocardiography also called targeted neonatal echocardiography or neonatologist performed echocardiography. It will review assessment of hemodynamics and cardiac function in neonatal hypotension and shock, suspected patent ductus arteriosus, suspected persistent pulmonary hypertension of the newborn with evaluation of pulmonary artery pressure and assessment of pericardial effusion. It will also emphasize the specific requirements for the practice and training of functional neonatal echocardiography.
在过去的十年中,超声心动图的作用发生了巨大的变化,功能超声心动图在新生儿科医生和儿科重症监护医生中越来越受欢迎,用于对患病婴儿和儿童做出临床决策。本文旨在概述功能超声心动图的当前能力和局限性、其临床应用的最佳实践以及其效用的证据。
功能超声心动图可以在床边直接评估血液动力学,可以作为新生儿重症监护病房的现代血液动力学监测工具。现在,它被认为是对重症婴儿临床检查和其他监测工具的有益补充。功能超声心动图提供的解剖、生理和血液动力学信息可用于针对特定干预措施,并评估治疗反应。
本文综述了功能新生儿超声心动图(也称为靶向新生儿超声心动图或由新生儿科医生进行的超声心动图)的最常见应用。它将回顾新生儿低血压和休克时的血液动力学和心功能评估、疑似动脉导管未闭、疑似新生儿持续性肺动脉高压时的肺动脉压评估和心包积液评估。它还将强调功能新生儿超声心动图的实践和培训的具体要求。