REVIEWS   Free access

Minerva Anestesiologica 2010 March;76(3):209-14

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Echocardiographic evaluation and clinical management of ductal shunting in hemodynamically unstable preterm neonates without congenital heart disease in the pediatric intensive care unit

Di Nardo M. ¹, De Matteis G. M. ², Cecchetti C. ¹, Pasotti E. ¹, Tomasello C. ¹, Marano M. ¹, Perrotta D. ¹, Stoppa F. ¹, Pirozzi N. ¹ ✉

¹ DEA-Area Rossa-ICU, Bambino Gesù Pediatric Hospital, Rome, Italy; ² Echocardiography Unit, Pertini Hospital, Rome, Italy

Although significant steps have been taken to monitor complex hemodynamics in neonatal and pediatric intensive care units, cardiovascular function in neonates is still evaluated by measuring blood pressure, heart rate, diuresis, central venous pressure (if a central venous catheter was placed), capillary refill time and oxygen saturation measurement in the upper and lower extremities. The use of other non-invasive or invasive technologies (for example, continuous impedance cardiography, transesophageal Doppler and continuous pulse contour methods) is, in fact, quite problematic in neonates in whom relevant hemodynamic changes are common during the transition to postnatal life. For these reasons, use of transthoracic echocardiography, performed by skilled pediatric intensivists, is increasing in several dedicated centers to guide treatment choices in hemodynamically unstable neonates.