Neonatal Unit, Homerton University Hospital, Homerton Healthcare NHS Foundation Trust, London, UK
Centre for Genomics and Child Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK.
BMJ Paediatr Open. 2024 Oct 14;8(1):e002606. doi: 10.1136/bmjpo-2024-002606.
Neonatologist-performed echocardiography (NPE) is increasingly used in the neonatal intensive care unit, aiding clinicians in enhancing diagnostic precision and guiding treatment decisions based on underlying pathophysiology. Experienced NPE operators typically use visual estimation of the cardiac contractility and if required confirm findings using quantitative echocardiographic markers.While various quantitative echocardiographic markers are available to assess left and right ventricular contractility, this study aims to compare the proficiency of NPE-experienced and non-experienced providers in accurately assessing cardiac contractility using a combination of commonly used qualitative and quantitative echocardiographic markers.
Newborn infants, both inborn and outborn, undergoing routine NPE by the authors at Homerton University Hospital and Aberdeen Maternity Hospital from 1 April 2024 to 1 October 2024 will be studied. Indications for NPE include murmur evaluation, infants receiving intensive care and the need to assess underlying cardiovascular physiology.Blinded experienced and non-experienced NPE operators will independently assess left and right ventricular contractility using qualitative echocardiographic markers. The results will be compared with standard quantitative echocardiographic markers for cardiac contractility, and reliability studies will also be conducted for quantitative makers.Clinical data will be sourced from electronic patient records and national neonatal database. Sensitivity, specificity, positive predictive and negative predictive values, and positive and negative likelihood ratios will be calculated.
The study is approved by the Health and Care Research Wales Research Ethics Committee and the Health Research Authority (HRA) (reference 23/HRA/3066). The study findings will be presented at national/international conferences and published in peer-reviewed scientific journals.
新生儿科医生进行的超声心动图（NPE）在新生儿重症监护病房中越来越多地被使用，帮助临床医生提高诊断准确性，并根据潜在的病理生理学指导治疗决策。经验丰富的 NPE 操作人员通常使用心脏收缩力的视觉估计，如果需要，使用定量超声心动图标志物来确认结果。虽然有各种定量超声心动图标志物可用于评估左心室和右心室收缩力，但本研究旨在比较 NPE 经验丰富和非经验丰富的提供者使用常用的定性和定量超声心动图标志物组合准确评估心脏收缩力的能力。
本研究将在 2024 年 4 月 1 日至 2024 年 10 月 1 日期间，由作者在 Homerton 大学医院和阿伯丁妇产医院对接受例行 NPE 的新生儿进行研究，这些新生儿包括在产儿和产儿。NPE 的适应证包括杂音评估、接受重症监护的婴儿以及评估潜在心血管生理学的需要。经验丰富和非经验丰富的 NPE 操作人员将使用定性超声心动图标志物独立评估左心室和右心室收缩力。结果将与标准的定量超声心动图心脏收缩力标志物进行比较，并且还将对定量标志物进行可靠性研究。临床数据将从电子患者记录和国家新生儿数据库中获取。将计算敏感性、特异性、阳性预测值和阴性预测值以及阳性和阴性似然比。
该研究已获得威尔士健康和护理研究伦理委员会和健康研究管理局（HRA）的批准（参考 23/HRA/3066）。研究结果将在国内/国际会议上展示，并发表在同行评议的科学期刊上。
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