5509
Shaimaa Abd Elkhalek Mohamed Hashem
The Value Of Functional Echocardiography In The Management Of Mechanically Ventilated Neonates
fECHO in neonates, PDA with fECHO, mechanical ventilation
Background: Functional echocardiography for the neonates is a targeted bedside cardiovascular ultrasound that aiming to clinical evaluation and management of the current neonatal hemodynamic changes. Objective: This prospective follow up study aimed at assessment of the hemodynamic changes in mechanically ventilated neonates, and determination of the correlation between ventilation settings and fECHO. Methods: fifty mechanically ventilated neonates due to noncongenital respiratory problems underwent fECHO after 24 hours of mechanical ventilation. Thirty neonates continued on mechanical ventilation and were available to 48 hours fECHO follow up. Results: A 24 hours fECHO examination showed; highly significant negative correlation between the RVO and the PIP & MAP (P value 0.01) and significant negative correlation with PEEP (P value 0.05). A significant negative correlation between the LVO and the MAP (P value 0.05). A highly significant negative correlation between SVC flow and PIP & MAP (P value 0.01), while no significant correlations found at 48 hours fECHO examination (P value 0.05). A 24 hours fECHO examination showed 14 patients had significant PDA. There was highly significant increase (P value 0.01) in PDA diameter, LA/AO ratio, LVO/SVC ratio, LPA, significant increase (P value 0.05) in LVO, and highly significant decrease (P value 0.01) in SVC flow of significant PDA patients more than non-significant PDA or closed patients. Conclusion: fECHO is an extension of the bedside clinical assessment for neonatal hemodynamic changes, it assisted in many decision taking such as closure of significant PDA, surfactant replacement therapy, increasing total fluid intake, management of pulmonary hypertension.
2017
Ph.d
Ain Shams
Institute of post graduate childhood studies