Background : Hemodynamic monitoring in neonates is an important determinant of cardiovascular function. Changes in systemic and regional perfusion during transition to extrauterine life must be monitored continuously. The management remains a challenge for neonatologist in many factors. Reliable data of clinical parameters to determine the disruption of circulation in monitoring hemodynamic and its initial management must be obtained precisely.
Material : This survey used questionnaires which were distributed among 23 NICUs in Indonesia.
Results : Among all of NICUs, 12 (52.2%) NICUs were located in the province’s capital. All NICUs (100%) didn’t use CVP procedure as monitoring equipment. Eight (34.8%) NICUs only used pulse oximetry as monitoring equipment and 8 (34.8%) NICUs used pulse oximetry and digital sphygmomanometer as monitoring equipment. Seven (30.4%) NICUs used blood pressure for hemodynamic monitoring in about 30% patients. Most of the NICUs didn’t have complete cuff’s size (60.9%). The highest parameter to determine the disruption of hemodynamic was hypotension (47,8%). Most initial therapy management was fluid rescucitation (95,7%). The clinical parameter for fluid rescucitation was heart rate and capillary refill time (69,6%). Blood pressure supportive drugs were chosen and adjusted based on heart rate and CRT (82,6% and 73,9% respectively).
Conclusions : Eventhough most of the NICUs didn’t have complete cuff’s size, blood pressure is still the most popular non-invasive hemodynamic monitoring. There’s an urgent need to train more neonatologist to master cardiac output monitor measuring technic to detect early hemodynamic instability in critical care newborns.
Keywords: Hemodynamic monitoring NICU Blood pressure Cardiac output
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