Abstract
Aim: To evaluate clinical practice, neonatologists’ attitudes,
the extent of training and accreditation regarding targeted neonatal
echocardiography (TnEcho) among Chinese neonatologists.
Methods: A web-based questionnaire was emailed to 124 randomly
chosen neonatologists at 55 tertiary neonatal intensive care units
(NICUs) from all regions of China. The survey covered various aspects of
TnEcho, including the characteristics of clinical practice, attitudes
towards its usefulness, perceived barriers of implementation and
training methods. Results: Survey response rate was 67.7%
(84/124). Thirty-six (42.9%) respondents stated that TnEcho was
utilized in their NICUs. Most respondents reported use of
echocardiography to evaluate hemodynamic significance of the patent
ductus arteriosus (PDA, 97.2%), myocardial performance in neonates with
sudden cardiorespiratory deterioration (97.2%). The most frequently
used parameters to identify hemodynamic significant PDA were ductal size
(88.9%) and doppler pattern (91.7%) of transductal flow respectively.
Most (83.3%) respondents measured tricuspid regurgitation to assess
pulmonary hemodynamics. All respondents positively valued the role of
TnEcho in providing timely and longitudinal hemodynamic information to
guide cardiovascular support. Lack of experienced practitioners with
echocardiography expertise and accredited training programs were
perceived to be the major barriers to implementation (82.1% and 81%,
respectively). Of concern, most practitioners with TnEcho skills
received training in an informal manner through self-directed learning
(66.7%) or workshops (66.7%). Conclusions: The use of TnEcho
for longitudinal evaluation of infants with hemodynamic stability is
growing within Chinese NICUs. There is an urgent need to develop
standardized training programs and accreditation for TnEcho which are
adapted to the Chinese context.