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Can J Physiol Pharmacol. 2019 Mar;97(3):183-186. doi: 10.1139/cjpp-2018-0458. Epub 2018 Oct 16.

Merits and perils of targeted neonatal echocardiography-based hemodynamic research: a position statement 1.

Author information

1
a Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada.
2
b Department of Paediatrics, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada.
3
c Department of Pediatrics, University of Iowa City, Iowa City, IA 52242, USA.
4
d Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada.

Abstract

In the neonatal setting, point-of-care ultrasound is increasingly being used to help clinicians with the evaluation of heart function. Practices in neonatology, particularly with regard to acute and chronic hemodynamic managements, were traditionally more driven on dogma and predefined thresholds and not always supported by demonstrable physiology. For the first time, targeted neonatal echocardiography (TNE) provided neonatal intensivists with a bedside tool that made real-time assessment of neonatal hemodynamics status feasible in even the tiniest of babies. This opened the door towards more targeted physiological driven practices, allowing us to test historical approaches to clinical problems in a more precise way. Despite the standardization of TNE training and the creation of a formalized curriculum, little attention has been paid to the establishment of an empirical framework to adjudicate scientific investigation. In this position statement, we reflect on the evolution of TNE in Canadian neonatal intensive care units, appraise its strengths and limitations, and suggest guiding principles for clinicians and researchers to consider as they take this field forward.

KEYWORDS:

echocardiography; hemodynamics; hémodynamie; neonate; néonatalogie; recherche; research; échocardiographie

PMID:
30326198
DOI:
10.1139/cjpp-2018-0458
[Indexed for MEDLINE]

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