title: The impact of integrated evaluation of hemodynamics using targeted neonatal echocardiography with indices of tissue oxygenation: a new approach.
abstract: To study the impact of integrated evaluation of hemodynamics (IEH) using targeted neonatal echocardiography, together with regional tissue oxygenation, fractional oxygen extraction using near-infrared spectroscopy on the management of infants with compromised hemodynamics.
  
  
  
  Retrospective cohort comparison of two groups of infants with compromised hemodynamics. EPOCH 1: did not undergo IEH (January 2012 to March 2014); EPOCH 2: underwent IEH (April 2014 to December 2015). The primary outcome was the time to recovery.
  
  
  
  In all, 340 infants were included; 158 underwent IEH with a median (IQR) of 2 (1 to 3) evaluations per infant. Reasons for assessment included PDA (60%), compromised systemic circulation (14%) and clinically suspected pulmonary hypertension (22%). The time to recovery was shorter in IEH group in patients with compromised systemic circulation median (IQR), 32 h (24 to 63) compared with none IEH group 71 h (36 to 96), pulmonary hypertension 63 h (14.2 to 102) in IEH group compared with 68 h (24 to 240) in none IEH group, there were fewer PDA-related complications in preterm infants with PDA in IEH group.
  
  
  
  IEH was associated with shorter time to clinical recovery in infants with compromised hemodynamics.
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Y N
authors.initials: YN
authors.lastname: Elsayed
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Amer
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: M M
authors.initials: MM
authors.lastname: Seshia
mesh_terms: D002170:Canada; D002560:Cerebrovascular Circulation; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008991:Monitoring, Physiologic; D010101:Oxygen Consumption; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D019265:Spectroscopy, Near-Infrared