Neonatal Intensive Care Unit, Maternal and Child Health Department, AO San Pio, Benevento, Italy.
Division of Cardiology, Interventional Cardiology, and Coronary Care Unit, Thoracic and Cardiovascular Department, AO San Pio, Benevento, Italy.
J Neonatal Perinatal Med. 2022;15(2):237-242. doi: 10.3233/NPM-210811.
The main goal of neonatologist performed echocardiography is to timely assess hemodynamic changes in order to properly manage unsteady neonates. Detailed structural heart assessment remains the domain of pediatric cardiologists. Nonetheless, many neonatologists take on an additional role in diagnosis of congenital heart defects, mostly compelled by the lack of in-house pediatric cardiology services. The experience of neonatologist performed echocardiography in an Italian neonatal unit was reported and the risk benefit profile of this practice was discussed.
We retrospectively reviewed the echocardiograms undertaken by the neonatologist on infants admitted to the neonatal unit and postnatal ward of the Hospital San Pio in Benevento, over a 2-year period. Details of scans and concordance between neonatologist and cardiologist were analyzed.
A total of 160 echocardiographic studies were done by the neonatologist on 136 infants. The ECG was requested in a minority of infants. The most common reason for performing the echocardiogram was admission to the neonatal care unit. Around half of the echocardiograms were normal. The remaining scans resulted in functional and structural abnormalities, transitional changes, and doubtful findings. Cardiac anomalies were significantly more likely found in cases of echocardiograms performed for fetal indications. Only 28 patients were eventually referred to the cardiology services. The inter-rater agreement was satisfactory.
The hemodynamic assessment of sick infants, as well as triaging and referral of neonates with structural heart diseases are valuable advantages of the echocardiography run by neonatologists.Collaboration with pediatric cardiologists and robust training and accreditation programs are essential to ensure safety and quality service.
新生儿科医生进行超声心动图的主要目的是及时评估血流动力学变化，以便对不稳定的新生儿进行适当的管理。详细的心脏结构评估仍然是儿科心脏病专家的领域。尽管如此，许多新生儿科医生在先天性心脏病的诊断中承担额外的角色，这主要是由于缺乏内部儿科心脏病学服务。本文报告了意大利新生儿病房的新生儿科医生进行超声心动图的经验，并讨论了这种做法的风险效益情况。
我们回顾性地分析了在贝内文托圣皮奥医院新生儿病房和产后病房住院的婴儿由新生儿科医生进行的超声心动图。分析了扫描的详细信息以及新生儿科医生和心脏病专家之间的一致性。
新生儿科医生共对 136 名婴儿进行了 160 次超声心动图检查。少数婴儿要求进行心电图检查。进行超声心动图的最常见原因是入住新生儿监护病房。大约一半的超声心动图正常。其余的扫描结果显示功能和结构异常、过渡性改变和可疑发现。在因胎儿指征而进行的超声心动图检查中，心脏异常明显更常见。最终只有 28 名患者被转诊至心脏病科。观察者间的一致性令人满意。
对患病婴儿进行血流动力学评估，以及对有结构性心脏病的新生儿进行分诊和转诊，是新生儿科医生进行超声心动图的有价值的优势。与儿科心脏病专家合作以及进行强有力的培训和认证计划对于确保安全性和高质量的服务至关重要。
