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A National Survey Study of Targeted Neonatal Echocardiography in China
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  • Juan Du,
  • Weiling Kong,
  • Ruimiao Bai,
  • Xiang Cao,
  • Patrick McNamara,
  • Yingping Deng
Juan Du
Beijing Children's Hospital Capital Medical University

Corresponding Author:[email protected]

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Weiling Kong
Children's Hospital of Fudan University
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Ruimiao Bai
Northwest Women and Children's Hospital
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Xiang Cao
Department of Neonatology Hainan Women and Children's Medical Center 75 South Longkun Road Haikou Hainan CHINA570312
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Patrick McNamara
The University of Iowa Stead Family Department of Pediatrics
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Yingping Deng
Children's Hospital of Fudan University
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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.