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Functional echocardiography training in the neonatal intensive care unit: comparing measurements and results with the pediatric cardiologist.

Abstract：

OBJECTIVES:Functional echocardiography is a valuable tool in the neonatal intensive care unit, but training programs are not standardized. The aim was to report an functional echocardiography training program for neonatologists and to describe the agreement of their measurements with the pediatric cardiologist. METHODS:Functional echocardiography training lasted 32h. After training program, the neonatologists performed functional echocardiography in the neonatal intensive care unit and were required to measure left cardiac chambers dimensions, left ventricle systolic function, right and left ventricular output, ductus arteriosus diameter, and flow pattern. Images were recorded by the equipment and reviewed offline by the pediatric cardiologist. The Bland-Altman test was used for quantitative variables and the kappa test, for qualitative variables. RESULTS:Twenty-two trained neonatologists performed 100 functional echocardiography exams. Ductus arteriosus identification and flow pattern had substantial agreement (kappa=0.91 and 0.88, respectively), as well as its diameter (mean difference=0.04mm). The mean difference for the aortic root was -1.2mm; left atrium, 0.60mm; left ventricle diastolic diameter, -0.90mm; left ventricle systolic diameter, -0.30mm. Shortening fraction and ejection fraction correlated well with broad limits of agreement, -2.96% (14.88; -20.82%) and --3.43% (15.54; -22.40%), respectively. Right and left ventricular output had broad limits of agreement, 16.69mL/kg/min (222.76; -189.37) and 23.57mL/kg/min (157.88; -110), respectively. There was good agreement between interpretations of normal or low cardiac output (76.7% for right ventricular output; 75.7% for left ventricular output). CONCLUSION:This functional echocardiography training program enabled neonatologists to obtain adequate skills in performing the images, obtaining good agreement with the cardiologist in simple hemodynamic measurements and ductus arteriosus evaluation.

journal_name

J Pediatr (Rio J)

journal_title

Jornal de pediatria

authors

Zamith MM,Figueira SAN,Oliveira AC,Metolina C,Castro JS,Santos CND,Capo ALOA,Moisés VA

doi

10.1016/j.jped.2019.04.006

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

614-620

issue

eissn

0021-7557

issn

1678-4782

pii

S0021-7557(19)30059-2

journal_volume

pub_type

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Functional echocardiography training in the neonatal intensive care unit: comparing measurements and results with the pediatric cardiologist.