Neonatologist Patrick McNamara, MD
Neonatologist Regan Giesinger, MD
When neonatologists Patrick McNamara, MD, and Regan Giesinger, MD, started the hemodynamic screening program at University of Iowa Stead Family Children’s Hospital in 2017, they aimed to increase survival rates and reduce complications for preterm babies.
Now, a new study is showing promising results.
The study—published in the May edition of the American Journal of Respiratory and Critical Care Medicine—shows that when hemodynamic screening was completed 24 hours after the birth of babies born at fewer than 27 weeks of gestation, the combined rate of death or severe brain bleeding fell by half. Hemodynamic screening was also linked to a lower incidence of several other complications such as severe lung disease and necrotizing enterocolitis.
Hemodynamics involves using ultrasound to obtain detailed images of a baby’s heart, valves, and vessels, which allows doctors to assess heart function and blood flow to all parts of the body.
“This work is precedent-setting for neonatology,” says McNamara, professor of pediatrics and director of the Division of Neonatology.
The UI team followed 423 babies, born before 27 weeks, between January 2010 and December 2017. This control group did not get hemodynamic screening and is representative of the situation at most high-level NICUs in the U.S. They also followed 191 babies, also born before 27 weeks, between October 2018 and April 2022. All these babies received hemodynamic screening 12 to 18 hours after birth.
The hemodynamic screening group had lower levels of all the adverse events measured: severe brain bleeding, death, death within the first week of life, necrotizing enterocolitis, and severe bronchopulmonary dysplasia.
Editor’s note: Giesinger died in May 2023. Her last study “provided landmark findings that will have a huge impact on the care of these tiny babies in the future,” McNamara says.
