Advanced hemodynamic monitoring of the heart and fetal channels in newborn infants using ultrafast ultrasound blood flow imaging

There is much controversy about optimal management of patent ductus arteriosus
(PDA)
in preterm infants, with the risk of over- and undertreatment. It is
hypothesized that with the use of ultrafast ultrasound blood flow imaging it is
possible to objectively and accurately quantify 2D flow patterns through this
fetal channel. This new technique will provide quantitative measures, which
will potentially enable us to generate new parameters to predict spontaneous
closure of the PDA.

The primary objective of this study is to optimize the ultrafast ultrasound
flow imaging technique for intra and extra cardiac flow visualization in
neonates. The secondary objectives are 1) to compare cardiac output determined
using conventional Doppler ultrasound versus ultrafast ultrasound imaging and
2) to gain an insight in the 2D flow patterns involved during closure of the
PDA.

This study is a prospective, non-randomized, observational, single-center
study. In the study both conventional Doppler ultrasound images and ultrafast
ultrasound images will be obtained and compared.

For 3 days, once a day two additional ultrasound examinations will be
performed: a conventional Doppler ultrasound and an ultrafast ultrasound. The
examinations take about 5 minutes each, but will be spread over a time period
of about half an hour because of the time it takes to save the ultrafast
images. This observational exam is associated with negligible risk according to
the risk analysis. Because the study focuses on hemodynamics associated with
PDA it is not possible to perform this study in any other patient group than
neonates.