ABSTRACT
Background: Functional echocardiography [ECHO] 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, determination of the correlation between ventilation settings and fECHO
Methods: fifty mechanically ventilated neonated due to non-congenital respiratory problem underwent fECHO after 24 hours of mechanical ventilation. Thirty neonates continued on mechanical ventilation and were available to 48 hours of fECHO follow up
Results: A 24 hours fECHO examination showed; highly significant negative correlation between the right ventricular output [RVO] and the peak inspiratory pressure [PIP] and mean airway pressure [MAP] [P value < 0.01] and significant negative correlation with positive and expiratory pressure [PEEP] [P value < 0.05]. A significant negative correlation between the left ventricular output [LVO] and the MAP [P value < 0.05]. A highly significant negative correlation between superior vena cava flow [SVC] flow and PIP and 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 patent ductus arteriosus [PDA]. There was highly 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