Utility of M-Mode Echocardiography for Early Identification of Infants with Persistent Pulmonary Hypertension of the Newborn

Publisher Website
Google Scholar
Abstract
The clinical syndrome of persistent pulmonary hypertension of the newborn (PPHN) still carries high mortality in spite of improved neonatal care. The utility of M-mode echocardiography for the early identification of infants with PPHN prior to clinical deterioration was assessed. Echocardiograms of 51 infnats who needed fractional inspiratory O2 (FIO2) .gtoreq. 0.25 to maintain adequate PaO2 [arterial partial pressure of O2] within 36 h of life were compared to those of 115 healthy full-term and preterm newborns. Of the 51 infants, 10 had elevated systolic time interval ratios of both ventricles simultaneously (ventricular pre-ejection period to ventricular ejection time [RPEP/RVET .gtoreq. 0.50, LPEP/LVET .gtoreq. 0.38]). All of these newborns had PPHN that was manifest clinically by 11-30 h of age. The echocardiographic findings preceded clinical deterioration by at least 1-5 h in all cases. The other 41 infants had clinical courses consistent with uncomplicated pulmonary disease. Systolic time interval ratios, although not accurate measures of pulmonary arterial pressure and/or pulmonary vascular resistance, permit early identification of infants with PPHN and separation from others with uncomplicated pulmonary disease.