Value of Targeted Neonatal Echocardiography

The clinical approach to the evaluation and management of hemodynamic instability in very low birthweight (VLBW) infants lacks scientific validation and often fails to consider physiologic factors. Systemic hypotension is common but methods used to determine the underlying etiology and accurately evaluate end-organ perfusion are limited.1 Tar-geted neonatal echocardiography (TnEcho) is being increas-ingly used to support hemodynamic decisions in VLBW infants as part of a framework of physiology-based care.2,3 We present a case which highlights the utility of TnEcho in determining the nature of cardiovascular compromise and monitoring treatment response. Case The index case was born at 26 weeks 5 days gestation with a birthweight of 1,020 g. His mother was a healthy 29-year-ol