Suciu Laura Mihaela, Prelipcean Irina, Făgărășan Amalia, Giesinger Regan E, McNamara Patrick J
Department of Pediatrics, University of Medicine Pharmacy Science and Technology George Emil Palade of Targu Mures, Targu Mures, Romania.
Department of Neonatology, University of Rochester Medical Center Golisano Children's Hospital at Strong, Rochester, NY, United States.
Front Pediatr. 2023 Jun 16;11:1192618. doi: 10.3389/fped.2023.1192618. eCollection 2023.
Recent research has increased focus and interest in characterizing the physiology of the transition circulation using echocardiography. Critique of published normative neonatal echocardiography data among healthy term neonates has not been performed. We have performed a comprehensive literature review using the key terms: cardiac adaptation, hemodynamics, neonatal transition, term newborns. Studies were included if they had reported echocardiography indices of cardiovascular function in the presence of maternal diabetes, intrauterine growth restricted newborns and prematurity and had a comparison group of healthy term newborns within first seven postnatal days. Sixteen published studies evaluating transitional circulation in healthy newborns were included. There was marked heterogeneity in the methodologies used; specifically, inconsistency in time of evaluation and imaging techniques used makes it challenging to determine specific trends of expected physiologic changes. Some studies revealed nomograms for echocardiography indices, though limitations persist in terms of sample size, number of reported parameters and consistency of measurement technique. A comprehensive standardized echocardiography framework which includes consistent techniques for assessment dimensions, function, blood flow, pulmonary/systemic vascular resistance, and shunts pattern is warranted to ensure consistency in the use of echocardiography to guide care of healthy and sick newborns.
最近的研究增加了使用超声心动图来描述过渡循环生理学特征的关注度和兴趣。尚未对已发表的健康足月儿的标准新生儿超声心动图数据进行批判性分析。我们使用以下关键词进行了全面的文献综述：心脏适应、血流动力学、新生儿过渡、足月儿。如果研究报告了患有母亲糖尿病、宫内生长受限新生儿和早产儿的心血管功能的超声心动图指标，并且有一个健康足月儿的对照组在出生后前七天内，则将其纳入研究。纳入了16项评估健康新生儿过渡循环的已发表研究。所使用的方法存在明显的异质性；具体而言，评估时间和所使用的成像技术不一致，使得确定预期生理变化的具体趋势具有挑战性。一些研究揭示了超声心动图指标的列线图，尽管在样本量、报告参数的数量和测量技术的一致性方面仍然存在局限性。需要一个全面的标准化超声心动图框架，其中包括用于评估尺寸、功能、血流、肺/体循环血管阻力和分流模式的一致技术，以确保在使用超声心动图指导健康和患病新生儿护理方面的一致性。
