9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Transthoracic Echocardiography of the Neonatal Laboratory Piglet

      research-article

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Newborn piglets are commonly used in biomedical research. However, cardiovascular imaging of this species is quite challenging. For point of care diagnostics of heart function transthoracic echocardiography may be used, which appears to differ comparing newborn piglets with adult pigs. To date, there are few data or studies on the feasibility and quality of measurement of functional echocardiographic parameters in very small neonatal piglets.

          Objectives: To study the feasibility of transthoracic echocardiography in very small newborn piglets in supine position.

          Methods: In 44 anesthetized and intubated newborn piglets, positioned in supine position [age 32 h (12–44 h), weight 1,220 g (1,060–1,495 g), median (IQR)] transthoracic echocardiography was performed using a point of care ultrasound device (M-Turbo ©, FujiFilm SonoSite BV, Amsterdam, Netherlands), and a standard ultrasound transducer.

          Results: Using 2D- and M-mode-imaging left- and right-sided heart structures were accessible to transthoracic echocardiography in neonatal piglets. Diameters of the interventricular septum, the left ventricle, and the posterior wall were measured and ejection fraction and shortening fraction was calculated. Both left and right ventricular outflow tract could be imaged, and ventricular filling and systolic function could be evaluated. Furthermore, we were able to assess shunts of fetal circulation, such as patent ductus arteriosus, structure of the heart valves and congenital heart defects including ventricular septal defect.

          Conclusions: In summary, transthoracic echocardiography is feasible for assessment of cardiovascular function even in very small newborn laboratory piglets in supine position.

          Related collections

          Most cited references29

          • Record: found
          • Abstract: found
          • Article: not found

          Measurement of cardiac function using pressure-volume conductance catheter technique in mice and rats.

          Ventricular pressure-volume relationships have become well established as the most rigorous and comprehensive ways to assess intact heart function. Thanks to advances in miniature sensor technology, this approach has been successfully translated to small rodents, allowing for detailed characterization of cardiovascular function in genetically engineered mice, testing effects of pharmacotherapies and studying disease conditions. This method is unique for providing measures of left ventricular (LV) performance that are more specific to the heart and less affected by vascular loading conditions. Here we present descriptions and movies for procedures employing this method (anesthesia, intubation and surgical techniques, calibrations). We also provide examples of hemodynamics measurements obtained from normal mice/rats, and from animals with cardiac hypertrophy/heart failure, and describe values for various useful load-dependent and load-independent indexes of LV function obtained using different types of anesthesia. The completion of the protocol takes 1-4 h (depending on the experimental design/end points).
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France, 27-28 April 2006.

            Shock is a severe syndrome resulting in multiple organ dysfunction and a high mortality rate. The goal of this consensus statement is to provide recommendations regarding the monitoring and management of the critically ill patient with shock. An international consensus conference was held in April 2006 to develop recommendations for hemodynamic monitoring and implications for management of patients with shock. Evidence-based recommendations were developed, after conferring with experts and reviewing the pertinent literature, by a jury of 11 persons representing five critical care societies. A total of 17 recommendations were developed to provide guidance to intensive care physicians monitoring and caring for the patient with shock. Topics addressed were as follows: (1) What are the epidemiologic and pathophysiologic features of shock in the ICU? (2) Should we monitor preload and fluid responsiveness in shock? (3) How and when should we monitor stroke volume or cardiac output in shock? (4) What markers of the regional and micro-circulation can be monitored, and how can cellular function be assessed in shock? (5) What is the evidence for using hemodynamic monitoring to direct therapy in shock? One of the most important recommendations was that hypotension is not required to define shock, and as a result, importance is assigned to the presence of inadequate tissue perfusion on physical examination. Given the current evidence, the only bio-marker recommended for diagnosis or staging of shock is blood lactate. The jury also recommended against the routine use of (1) the pulmonary artery catheter in shock and (2) static preload measurements used alone to predict fluid responsiveness. This consensus statement provides 17 different recommendations pertaining to the monitoring and caring of patients with shock. There were some important questions that could not be fully addressed using an evidence-based approach, and areas needing further research were identified.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Echocardiographic Evaluation of Ventricular Function—For the Neonatologist and Pediatric Intensivist

              In the neonatal and pediatric intensive care setting, bedside cardiac ultrasound is often used to assess ventricular dimensions and function. Depending upon the underlying disease process, it is necessary to be able to evaluate the systolic and diastolic function of left and or right ventricles. The systolic function of left ventricle is mostly assessed qualitatively on visual inspection “eye-balling” and quantitatively by measuring circumferential fraction shortening or calculating the ejection fraction by Simpson’s planimetry. The assessment of left ventricular diastolic function relies essentially on the mitral valve and pulmonary venous Doppler tracings or tissue Doppler evaluation. The right ventricular particular shape and anatomical position does not permit to use the same parameters for measuring systolic function as is used for the LV. Tricuspid annular plane systolic excursion (TAPSE) and S′ velocity on tissue Doppler imaging are more often used for quantitative assessment of right ventricle systolic function. Several parameters proposed to assess right ventricle systolic function such as fractional area change, 3D echocardiography, speckle tracking, and strain rate are being researched and normal values for children are being established. Diastolic function of right ventricle is evaluated by tricuspid valve and hepatic venous Doppler tracings or on tissue Doppler evaluation. The normal values for children are pretty similar to adults while normal values for the neonates, especially preterm infants, may differ significantly from adult population. The normal values for most of the parameters used to assess cardiac function in term neonates and children have now been established.
                Bookmark

                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                31 July 2019
                2019
                : 7
                : 318
                Affiliations
                [1] 1Division of Neonatology and Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, Ulm University , Ulm, Germany
                [2] 2Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, Ulm University , Ulm, Germany
                [3] 3Division of Neonatology, Department of Pediatrics, Sidra Medicine , Doha, Qatar
                Author notes

                Edited by: Eugene Dempsey, University College Cork, Ireland

                Reviewed by: Anup C. Katheria, Sharp Mary Birch Hospital for Women & Newborns, United States; Anne Lee Solevåg, Akershus University Hospital, Norway

                *Correspondence: Marc R. Mendler marc.mendler@ 123456uniklinik-ulm.de

                This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics

                †These authors have contributed equally to this work

                Article
                10.3389/fped.2019.00318
                6684740
                8217e74d-1730-44d4-ae06-90e0a852159d
                Copyright © 2019 Schwarz, Kalbitz, Hummler and Mendler.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 March 2019
                : 12 July 2019
                Page count
                Figures: 6, Tables: 1, Equations: 0, References: 30, Pages: 8, Words: 4453
                Categories
                Pediatrics
                Original Research

                neonatal transthoracic echocardiography,piglets,hemodynamic monitoring,ventricular function,swine

                Comments

                Comment on this article