Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

The aim of this study was to evaluate the role of functional echocardiography (fECHO) in Neonatal Intensive Care Units (NICU) especially in hemodynamically unstable neonates and to assess response to treatment. Methods: 45 neonates were enrolled: thirty hemodynamically unstable neonates admitted to NICU Cairo University hospitals and fifteen healthy neonates as controls. Neonates with complex heart disease were excluded. fECHO was done for all neonates and follow up study to the cases within 48 hours. Each study included assessment of Superior Vena Cava flow (SVCF), Left Ventricle outflow (LVOF), Right Ventricle outflow (RVOF), Patent ductus arteriosus (PDA), Patent foramen ovale (PFO) or Atrial septal defect (ASD) if present, ejection fraction (EF), Fractional shortening (FS) and Estimated systolic pulmonary artery pressure (ESPAP), determination of Tricuspid valve annular velocity by tissue Doppler and detection of pericardial effusion or intracardiac masses. Resluts: In controls, mean value of SVCF, LVOF and RVOF were 85.3± 7.3 , 144.1 ± 12.3 and 110.9 ±9.4 ml/kg/min respectively. Our cases were subdivided into: PDA group ( 33.3 %) and Sepsis group ( 66.7 %). In sepsis group, SVCF was lower than in controls and increased after treatment (Intensive fluid therapy, Inotropes and antibiotics). Cut-off criterion for SVCF was {u2264}66.9 ml/kg/min . LVOF in PDA group was higher than in controls and decreased after fluid restriction and Ibuprofen. RVOF in cases and controls were initially comparable; however it increased in cases following treatment. There was no difference in EF between cases and controls with no correlation with LVOF. Four cases died (13.3%) but no correlation between fECHO parameters and survival was established

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