Targeted Neonatal Echocardiography and Neonatal Hemodynamics in the Kingdom of Saudi Arabia: A One-Year Experience in Service Implementation.

OBJECTIVE

To evaluate the impact of a newly established targeted neonatal echocardiography (TNE) and Neonatal Hemodynamics consultation service on the assessment and management of neonates.

METHODS

This is a descriptive retrospective cohort study that included all neonates who underwent TNE consultations in the Neonatal Intensive Care Unit from October 2023 and September 2024. Clinical indications, diagnostic findings, and subsequent management were analyzed.

RESULT: A total of 237 TNE consultations were performed for 105 neonates. The mean gestational age was 29.9 weeks, and the mean birth weight was 1433 grams. On average, 19.8 echocardiographic scans were performed per month. The leading indications for consultation were assessment of patent ductus arteriosus (PDA) (43%), acute pulmonary hypertension (16.4%), screening for chronic pulmonary hypertension (18.6%), neonatal hypotension (17.7%), heart function (0.8%), and central line assessment (3.4%). Among the cohort, 83 neonates (79%) received targeted interventions based on TNE findings. Of these, 38 neonates (36.2%) born at <30 weeks' gestation were treated with pharmacologic agents for PDA closure. Twenty-three neonates (22%) received inhaled nitric oxide and inotropes for acute pulmonary hypertension, while 22 neonates (21%) received inotropes or vasopressors for neonatal hypotension.

CONCLUSION

The implementation of a dedicated TNE consultation service was associated with high utilization and had a measurable impact on clinical decision-making. While PDA assessment remained the most common indication, a substantial proportion of consultations supported management in cases of pulmonary hypertension and hypotension.