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S Noori, I Seri
OBJECTIVE: To investigate the effect of targeted neonatal echocardiography (TnEcho) on heart rate, arterial oxygen saturation (SPO2), cerebral regional oxygen saturation (CrSO2) and cerebral fractional oxygen extraction (CFOE) in extremely preterm infants during the first 3 postnatal days. STUDY DESIGN: s a nested study in a prospective observational study, we acquired continuous data on heart rate, SPO2, CrSO2 and CFOE. Data averaged for the duration of TnEcho study were compared with the data collected during a baseline period immediately before the start of echocardiography...
November 2014: Journal of Perinatology: Official Journal of the California Perinatal Association
Dany E Weisz, Wei Bing Poon, Andrew James, Patrick J McNamara
Systemic hypotension is common in very low birthweight preterm infants but the nature of the precipitating cause may be unclear. Targeted neonatal echocardiography (TnEcho) is being increasingly used to support hemodynamic decisions in the neonatal intensive care unit (NICU), including identifying impairments in the transitional circulation of preterm infants, providing timely re-evaluation after institution of therapies and evaluating the placement of indwelling catheters. We present a case of a preterm infant with systemic hypotension and low cardiac output secondary to a large transatrial shunt induced by a malpositioned umbilical venous catheter...
May 2014: American Journal of Perinatology Reports
A S Pulickal, P K Charlagorla, S C Tume, M Chhabra, P Narula, A M Nadroo
OBJECTIVES: To compare targeted neonatal echocardiography (TnECHO) and antero-posterior (AP) chest radiographs in the localization of the umbilical venous catheter (UVC) tip and to determine the accuracy of UVC tip localization by TnECHO when performed by a trained cohort of pediatric housestaff physicians. STUDY DESIGN: Prospective, observational study of consecutive neonates requiring UVC insertion, in a tertiary care center, in an 18-month period. Chest radiographs reporting optimal position of the UVC tip were compared with the TnECHO results of the pediatric cardiologist...
December 2013: Journal of Perinatology: Official Journal of the California Perinatal Association
A El-Khuffash, C Herbozo, A Jain, A Lapointe, P J McNamara
OBJECTIVE: To characterize the effect of a targeted neonatal echocardiography (TnECHO) program on decision making in a tertiary level unit. STUDY DESIGN: Retrospective cohort study of neonates, admitted between September 2007 and April 2011. Details of the TnECHO, and the clinical decisions within 6 h of the consultation were recorded. RESULT: A total of 199 infants underwent 512 echocardiograms with a median (interquartile range) of 2 (1 to 3) TnECHO studies per infant...
September 2013: Journal of Perinatology: Official Journal of the California Perinatal Association
Amish Jain, Patrick J McNamara, Eugene Ng, Afif El-Khuffash
The use of plain radiographs in assessing the correct position of peripherally inserted central catheter (PICC) line tips is not always accurate. Ultrasound may be a better modality in detecting tip position and aid in line manipulation. We assessed the accuracy of plain radiographs in determining PICC line tip position compared with using targeted neonatal echocardiography (TnECHO) in a tertiary neonatal intensive care unit. Following PICC insertion, tip position was confirmed using TnECHO after the first radiograph...
February 2012: American Journal of Perinatology
Amish Jain, Mohit Sahni, Afif El-Khuffash, Emad Khadawardi, Arvind Sehgal, Patrick J McNamara
OBJECTIVES: To investigate the value of targeted neonatal echocardiography (TnECHO) in predicting cardiorespiratory instability after patent ductus arteriosus (PDA) ligation, and to evaluate the impact of TnECHO-directed care. STUDY DESIGN: We reviewed serial echocardiography evaluations of 62 preterm infants after PDA ligation to investigate the relationship between indices of myocardial performance and postoperative cardiorespiratory instability. A predictive model was developed based on TnECHO criteria, with targeted initiation of intravenous milrinone...
April 2012: Journal of Pediatrics
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