title: Functional Neonatal Echocardiography: Indian Experience.
abstract: BACKGROUND
  Functional echocardiography, as opposed to echocardiography as performed by the cardiologist, is the bedside utilization of cardiac ultrasound to take after functional and haemodynamic changes longitudinally. Information reflecting cardiovascular capacity and systemic and pulmonary blood flow in sick preterm and term neonates can be observed utilizing this strategy. Information is lacking on its use in neonatal units in India.
  
  
  OBJECTIVE
  To characterize the impact of Functional neonatal echocardiography (FnECHO) programme on decision making in a tertiary care centre in India by evaluating its frequency of use, patient characteristics, and indications.
  
  
  METHODS
  Prospective observational study of neonates in a tertiary Neonatal Intensive Care Unit (NICU) in Pune (India) from February 2014 to January 2015. All the neonates undergoing FnECHO during this 12 month period based on clinical findings were included in the study. Data extracted from the review of the clinical notes included gestational age, birth-weight, mode of delivery, Apgar scores, details of respiratory and cardiovascular support, timing of FnECHO and any other clinical diagnosis. The findings of echocardiography were recorded and correlated with the clinical and other laboratory or X-ray findings. If these findings indicated a change in management, it was instituted.
  
  
  RESULTS
  A total of 348 echocardiographic studies were performed in 187 neonates (mean 1.86; SD 2.02). The most frequent indication was Patent Ductus Arteriosus (PDA) assessment (n= 174, 50%), followed by haemodynamic instability (n=43, 12.36%). The results of FnECHO modified treatment in 148 cases (42.50%) in the form of addition and/or change in the treatment or avoidance of unnecessary intervention.
  
  
  CONCLUSIONS
  FnECHO is frequently used in the NICU setting and may be a useful tool to guide treatment. PDA assessment and haemodynamic instability are the most frequent indications. To validate its usefulness, well co-ordinated large prospective studies are needed.
authors.affiliation: Assistant Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Anilkumar Mohan
authors.initials: AM
authors.lastname: Khamkar
authors.affiliation: Professor and Head, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Pradeep B
authors.initials: PB
authors.lastname: Suryawanshi
authors.affiliation: Consultant Neonatologist, Westmead Hospital , Westmead, NSW, Australia .
authors.forename: Rajesh
authors.initials: R
authors.lastname: Maheshwari
authors.affiliation: Assistant Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Suprabha
authors.initials: S
authors.lastname: Patnaik
authors.affiliation: Associate Professor, Department of Neonatology, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Nandini
authors.initials: N
authors.lastname: Malshe
authors.affiliation: Professor, Department of Paediatrics, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Kalrao
authors.affiliation: Professor and Head, Department of Pediatrics, BVU Medical College , Pune, Maharashtra, India .
authors.forename: Sanjay
authors.initials: S
authors.lastname: Lalwani
authors.affiliation: Assistant Professor, Department of PSM, MNR Medical college and Hospital , Sangareddy, Andhra Pradesh, India .
authors.forename: Jitendra
authors.initials: J
authors.lastname: Surwade
keywords: Neonatal intensive care unit; Neonate; Patent ductus arteriosus; Point of care
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