The aim of the present prospective study was to evaluate dynamic changes in both pulmonary artery pressure and ductus arteriosus during the first 72 hours after birth.
Healthy newborn infants born in Alexandria University Children's Hospital were studied. Dynamic changes during the first 72 hours after birth were evaluated.
Study Type
OBSERVATIONAL
Enrollment
110
Neonatal Intensive Care Unit (NICU) of Alexandria University Maternity Hospital.
Alexandria, Egypt
Pulmonary artery pressure (PAP) assessment - Tricuspid valve regurgitation peak velocity
This is measured in apical 4 chamber view, with continuous wave Doppler using modified Bernoulli equation. Systolic pulmonary artery pressure is equivalent to right ventricular systolic pressure in absence of outflow obstruction. Systolic Pulmonary Artery Pressure (SPAP) = Right Ventricular Systolic Pressure = 4x TR2 + Right Atrial Pressure (RAP) (RAP= 3-5 mmHg)
Time frame: up to 72 hours
Pulmonary artery pressure (PAP) assessment - Pulmonary regurgitation peak velocity
This is measured in short axis parasternal view with continuous wave Doppler using this equation: Mean Pulmonary Artery Pressure MPAP= 4xPR2 + Right Ventricular Diastolic Pressure (RVdP=2-5 mmHg)
Time frame: up to 72 hours
Pulmonary artery pressure (PAP) assessment - Transductal right-to-left flow peak velocity
This is measured in high short axis ductal view with continuous wave Doppler
Time frame: up to 72 hours
Pulmonary artery pressure (PAP) assessment - Interventricular septum configuration
This is measured in short axis parasternal view above level of papillary muscles, left ventricle is normally O shaped, D or crescent shape indicated bowing of septum due to RV dysfunction.
Time frame: up to 72 hours
Pulmonary artery pressure (PAP) assessment - Left ventricle systolic eccentricity index (LV-sEI)
This is measured in short axis parasternal view by measuring LV dimensions the parallel versus the perpendicular dimension. The normal ratio is 1.
Time frame: up to 72 hours
Right ventricular performance - Tricuspid annular plane systolic excursion(TAPSE)
This is measured using Mmode in apical 4 chamber view over lateral annulus of tricuspid valve
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Time frame: up to 72 hours
Right ventricular performance - Myocardial Performance Index (MPI)
This is measured by using pulsed wave doppler to measure isovolumetric ejection time + isovolumetric relaxation time/ right ventricular ejection time.
Time frame: up to 72 hours
Right ventricular performance - E/A ratio
This is measured in apical 4 chamber view by pulsed wave Doppler on mitral valve. The cut off value: 0.8- 2.
Time frame: up to 72 hours
Left ventricular performance - Ejection fraction
This is measured using M-Mode in long axis parasternal view with a normal range of 55-75%
Time frame: up to 72 hours
Left ventricular performance - E/A ratio
This is measured in apical 4 chamber view by pulsed wave Doppler on mitral valve. The cut off value: 0.8- 2
Time frame: up to 72 hours
Shunts evaluation - Patent Ductus arteriosus
Size will be evaluated in short axis parasternal view
Time frame: up to 72 hours
Shunts evaluation - Patent Ductus arteriosus
Direction will be evaluated in short axis parasternal view using color Doppler
Time frame: up to 72 hours
Shunts evaluation - Patent Foramen Ovale
Size will be evaluated in be viewed in subcostal view
Time frame: up to 72 hours
Shunts evaluation - Patent Foramen Ovale
Direction will be evaluated in subcostal view using color Doppler
Time frame: up to 72 hours