Clinical cardiac assessment in newborns with prenatally diagnosed intrathoracic masses

Abstract

BackgroundCongenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Our study aims to assess cardiac involvement during post-natal adaptation.MethodsA retrospective study was carried out on newborns with prenatally diagnosed intrathoracic mass. Gathering for respiratory distress syndrome (RDS), 35 neonates were compared for clinical course, cardiovascular enzymes, ECG, and ultrasound.ResultsThe analysis revealed a high left heart defect rate in patients with severe RDS, without being influenced by the laterality. Ultrasound or laboratory assessment did not detect altered cardiac dimension or cardiomyopathy. Solely ECG signs of right ventricular strain were found. Increased QT-dispersion, T-wave and cardiac variability alterations in the first hours were all expression of non-specific cardiac repolarization disorders but predict worse outcome.ConclusionsAlthough RDS is the predominant symptom, slight cardiac dysfunctions should be recognized for prompt treatment. Conventional examinations for postnatal adaption should be integrated by complementary investigations.

Neonatal heart rate variability: a contemporary scoping review of analysis methods and clinical applications

“…The most commonly studied conditions were sepsis (n=20) and HIE (n=19) ( table 5 ). There were 37 articles that examined 27 other conditions: cardiorespiratory events, 30 119 120 abnormal fetal status, 107 121–123 unplanned intubation, 124 hypotension, 21 105 125 abnormal polysomnography, 101 126 neonatal abstinence syndrome, 56 127 128 Transport Risk Index of Physiologic Stability score, 29 129 hyperbilirubinaemia, 104 128 130 Score for Neonatal Acute Physiology score, 131 132 delivery complications, 107 123 clinical course score, 21 105 risk of neurodevelopmental impairment, 133 gastro-oesophageal reflux disease, 134 bronchopulmonary dysplasia, 135 inflammatory cytokines, 81 fetal growth restriction, 136 cardiovascular development, 137 APGAR score (newborn health assessment of Appearance, Pulse, Grimace, Activity, and Respiration), 137 retinopathy of prematurity, 138 intrathoracic masses, 139 stroke, 78 antibiotic use, 140 non-benign tachyarrhythmia, 141 death/disability score, 142 T-wave alternans, 143 epigenetic ageing 144 and Clinical Risk Index for Babies (CRIB) score. 45 125 …”