A narrative review of Neonatal Echocardiography Simulator Training (NEST): role of simulators in acquiring neonatal echocardiography skills effectively.

Neonatologist performed echocardiography (NPE) is fast becoming as an essential tool to provide high-quality patient care in the neonatal intensive care units (NICU), especially to infants with hemodynamic instability. With limited training opportunities in the neonatal intensive care setting, learning echocardiography and implementation of published neonatal echocardiography training guidelines remain a challenge for the vast majority of neonatologists across the world. Hence, these guidelines have recommended the use of simulators for the initial echocardiography training.

Evaluation of Biventricular Diastolic Function in Preterm Infants in the First Week of Postnatal Life.

Diastolic dysfunction contributes significantly to respiratory instability in preterm infants but remains under-characterized during early postnatal transition. We aimed to evaluate the evolution of biventricular diastolic function during the first week of life in very low birth weight (VLBW) preterm infants. In this prospective observational study, 20 preterm infants (< 32 weeks gestation or < 1500 g) underwent serial echocardiograms at 24, 48, 72 h, and day 7.

Effect of assessing velocity time integral at different locations across ventricular outflow tracts when calculating cardiac output in neonates.

This study aims to evaluate the effect of assessing velocity time integral at different locations across ventricular outflow tracts for calculating cardiac output (CO) in neonates. Velocity time integral (VTI) and CO were measured at 3 different locations across right and left ventricular outflow tracts using transthoracic echocardiography in healthy term neonates without any major congenital heart disease. ANOVA with Bonferroni correction was used to determine the differences between the VTI and CO sampled at these three locations.

Outcomes of patent foramen ovale greater than 3 mm at birth in extremely low birthweight infants.

Background: Foramen ovale (FO) is an obligate fetal shunt that typically resolves after birth, although patency throughout life is not uncommon. The natural history of patent FO (PFO) is known in term infants, but less is known about its course in extremely preterm infants. We describe the echocardiographic changes in FO size from birth to discharge in extremely low birth weight (ELBW) infants in this retrospective study.

Pulmonary hemorrhage in extremely low birth weight infants: Significance of the size of left to right shunting through a valve incompetent patent foramen ovale.

Objective: Pulmonary hemorrhage is a rare but severe complication of extremely low birth weight (ELBW) infants. The association of hemodynamically significant patent ductus arteriosus (hsPDA) and the diameter of the foramen ovale (FO) with pulmonary hemorrhage has not been reported.

Study Design: Case control study of ELBW infants with and without pulmonary hemorrhage.

Effectiveness of Simulation Training in Acquiring Echocardiography Skills among Neonatology Care Providers.

Objectives: The objective of this study was to test the hypothesis that simulation training improves echocardiography skills.

Study Design: In this prospective study, 43 participants (16 neonatologists, 26 neonatology fellows, and 1 nurse practitioner) were tested on the simulator after 4 hours of didactic sessions on topographical cardiac anatomy and standard echocardiographic views. Participants were given 20 minutes to obtain and save the standard views.

Pulmonary Venous Congestion and Pulmonary Hemorrhage in an Extremely Premature Neonate With a Large Patent Ductus Arteriosus and Closed Patent Foramen Ovale: A Case Report.

We describe a case of an extremely low birthweight infant with a large patent ductus arteriosus and closed foramen ovale resulting in markedly increased pulmonary blood flow, pulmonary venous congestion, and pulmonary hemorrhage.

Development and validation of an automated assessment tool of echocardiography skills acquired on a neonatal simulator.

Introduction: Simulators are increasingly used for training in echocardiography. However, there is no objective method to assess the skills acquired. Our objective was to develop and test an automated method to assess echocardiography skills.

Systemic to Pulmonary Collaterals in Extremely Low Birth Weight Infants: Incidence, Clinical Significance, and Hemodynamic Features.

Objective: This study aimed to determine the incidence of systemic to pulmonary collaterals (SPCs) in extremely low birth weight infants and to assess its clinical and hemodynamic significance beyond the neonatal period.

Study Design: Retrospective cohort study was conducted on 61 infants with echocardiogram performed at the time of discharge to determine the presence of SPC and to measure the right and left ventricular outputs and left atrium to aortic ratio. We compared two groups: small or no SPC (Group 1) to moderate or large SPC (Group 2) on demographics, clinical outcomes, and echocardiographic parameters.

Virtual Neonatal Echocardiographic Training System (VNETS): An Echocardiographic Simulator for Training Basic Transthoracic Echocardiography Skills in Neonates and Infants.

There is a great need for training in pediatric echocardiography. In addition to physicians being trained in pediatric cardiology and echocardiography technologists, neonatologist, pediatric intensivists, and other health care professionals may be interested in such training. Since, there is limited opportunity of training on live patients, echocardiographic simulators may be of help.

Association of high level of hs-CRP with in-stent restenosis: A case-control study.

Background: In-stent restenosis (ISR) is one adverse outcome of coronary stent implantation. Although using drug-eluting stents has reduced the rate of ISR, it remains a major problem. Here, we have investigated the relationship between several patient characteristics including serum high sensitive C-reactive protein (hs-CRP) and ISR.

Anomalous Left Coronary Artery from the Pulmonary Artery Presenting with Atypical Chest Pain in an Adult: A Case Report.

The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical course is severe left-sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases, the collateral blood supply from the right coronary artery is sufficient and symptoms may be subtle or even absent.

Evaluation of natural radioactivity content in high-volume surface water samples along the northern coast of Oman Sea using portable high-resolution gamma-ray spectrometry.

Portable high-resolution gamma-ray spectrometry was carried out to determine the natural radioactivity levels in high volume surface water samples of the northern coast of Oman Sea, covering the coastal strip from Hormoz strait to Goatr seaport, for the first time. The water samples from 36 coastal and near shore locations were collected for analysis. Analyses on the samples collected were carried out to determine (226)Ra, (232)Th and (40)K contents.

The mechanical PR interval in fetuses of women with intrahepatic cholestasis of pregnancy.

Objective: The purpose of this study was to evaluate the fetal mechanical PR interval in intrahepatic cholestasis of pregnancy (ICP).

Study Design: Fetal echocardiography was performed for women with ICP and control subjects. Clinical characteristics, total bile acids, and liver profile tests were compared between groups.

Hemodynamic changes after low-dosage hydrocortisone administration in vasopressor-treated preterm and term neonates.

Objective: We sought to investigate whether the increase in blood pressure and decrease in vasopressor support after hydrocortisone administration are associated with changes in systemic hemodynamics in neonates who receive high-dosage dopamine to maintain blood pressure at the lowest acceptable levels.

Methods: In this prospective, observational study, preterm and term neonates who required dopamine > or = 15 microg/kg per minute to maintain minimum acceptable blood pressure received intravenous hydrocortisone 2 mg/kg followed by up to 4 doses of 1 mg/kg every 12 hours. Fifteen preterm and 5 term neonates without a patent ductus arteriosus composed the study population.

A rare presentation of Pompe disease with massive hypertrophic cardiomyopathy at birth.

We report a term infant with Pompe disease presenting in the immediate newborn period. The infant was born at 40 weeks' gestation, weighing 3600 g to a 32 year-old black female. Infant presented at delivery with massive hypertrophic cardiomyopathy and pulmonary hypertension.

Cardiac abnormalities in children with sickle cell anemia.

Sickle cell anemia (SCA) results in chronic volume overload of the heart due to hemodilution. Previous echocardiographic studies of cardiac function in children with SCA have not accounted for these abnormal loading conditions. The objectives of this study were to (1) determine how the degree of anemia and transfusion status relate to cardiac findings and (2) evaluate cardiac function using load-independent parameters of function.