Functional echocardiography as a precision tool for hemodynamic risk stratification in preterm newborns: A multicenter observational study
DOI:
https://doi.org/10.33448/rsd-v15i1.50478Keywords:
Preterm infant, Echocardiography, Hemodynamics, Neonatal Intensive Care Unit, Prognosis.Abstract
Targeted Neonatal Echocardiography (TnECHO) has been used as an early hemodynamic screening tool in extremely preterm newborns, allowing real-time assessment of cardiovascular physiology and individualization of clinical management. The present study aims to evaluate the prognostic role of functional echocardiographic markers and investigate the impact of early hemodynamic screening guided by neonatal functional echocardiography (TnECHO) on neonatal morbidity and mortality in extremely preterm newborns. This multicenter observational study evaluated the prognostic role of functional echocardiographic markers and the impact of early screening guided by TnECHO on neonatal morbidity and mortality. Preterm newborns <27–28 weeks and/or <1,250 g were included, comparing those screened between 12 and 18 hours of life with a group under standard care. The primary outcome was death or severe intraventricular hemorrhage up to 36 weeks of postmenstrual age. The implementation of early screening was associated with a significant reduction in the composite outcome, from 29% to 16%, with a higher chance of survival free of severe intraventricular hemorrhage after adjustment. Early pulmonary hypertension identified by TnECHO stood out as the main prognostic marker. In summary, early TnECHO proved to be a useful tool for hemodynamic risk stratification and reduction of adverse outcomes in extremely preterm infants.
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Copyright (c) 2026 Myrella Evelyn Nunes Turbano, Isabelle Pinto Pires, Cândido de Almeida Athayde, Lúcio Eugênio Cerqueira Lopes, Juliana Alvarenga Rosa, Francisco Leandro de Lima, Carolyne Vilarinho Lima, Gabrielly Assunção Nunes Soares, Milena da Rocha Rodrigues Meneses, Vinicius Pinto Caferro, Victória Oliveira Serrati, Ramon Figueiredo Sampaio, Carlos Danilo da Penha Souza
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