Functional echocardiography; from physiology to treatment.

Area of Science:

• Neonatal Medicine
• Cardiovascular Physiology
• Medical Imaging

Background:

• Functional echocardiography (fECHO) is crucial for bedside assessment of myocardial function and hemodynamics in neonates.
• Assessing systemic and pulmonary blood flow, as well as shunts, is vital for critically ill infants.
• Understanding hemodynamic status guides therapeutic interventions in neonatal care.

Purpose of the Study:

• To review the utility of fECHO in assessing the hemodynamic condition of sick neonates.
• To describe clinical scenarios where fECHO aids in selecting appropriate cardiovascular support.
• To emphasize the role of fECHO in managing specific neonatal conditions.

Main Methods:

• Review of clinical applications of fECHO in neonatal intensive care.
• Focus on specific patient populations: very low birth weight infants with hypotension, ductus arteriosus management, pulmonary hypertension, perinatal asphyxia, and sepsis.
• Discussion of the integration of fECHO into clinical practice.

Main Results:

• fECHO enables longitudinal assessment of myocardial function and blood flow.
• It assists in determining the pathophysiological basis for cardiovascular support.
• Specific applications include managing hypotension, ductal patency, pulmonary hypertension, and sepsis-related compromise.

Conclusions:

• fECHO is an indispensable tool for bedside hemodynamic assessment in neonates.
• Its application can guide critical decisions regarding cardiovascular support.
• Establishing a 24/7 fECHO service requires collaboration, logistics, and training.