{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:56:25Z","timestamp":1792803385081,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Congenital diaphragmatic hernia (CDH) is a complex disease with significant morbidity and mortality. The use of echocardiography, traditionally a pediatric cardiology echocardiogram (PCE), has significantly advanced the management of CDH but its availability can be limited, and there are concerns regarding clinical stability during the assessment. Neonatologist\u2010performed targeted neonatal echocardiography (TNE) has been proposed as a supplementary modality in CDH. Herein, we evaluate the feasibility and safety of integrating early TNE and a focused assessment protocol in CDH care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, single\u2010center study of neonates with CDH who received either an initial PCE (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) or complete TNE (<jats:italic>n<\/jats:italic>\u00a0=\u00a020). The timing, images, and duration of the study were collected, as well as clinical stability data. A focused TNE protocol for cases of clinical instability was similarly evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite similar clinical risk predictors, TNE was performed sooner (mean 3.0\u00a0vs. 11.6\u00a0h, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001) and quicker (mean 25.9\u00a0vs. 44.4\u00a0min, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001) than a PCE. While fewer images were obtained (mean 102.0\u00a0vs. 143.2 images, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001), no cases of congenital heart disease were missed. TNE and PCE were equally well tolerated. When indicated, a focused TNE protocol was utilized that provided actionable information with a mean duration of 7.2\u00a0min (<jats:italic>n<\/jats:italic>\u00a0=\u00a04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TNE can be performed early, quickly, and safely in neonates with CDH. A focused TNE protocol may be useful even in non\u2010TNE centers for the acute care of critically ill neonates with CDH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70189","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T10:50:36Z","timestamp":1747133436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Safety and Feasibility of Early Targeted Neonatal Echocardiography and a Focused Assessment Protocol in Neonates With Congenital Diaphragmatic Hernia"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9655-6449","authenticated-orcid":false,"suffix":"Jr","given":"John T.","family":"Wren","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Neonatology, University of Iowa Healthcare  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael M.","family":"Hyland","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology, University of Iowa Healthcare  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Acosta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology University of Iowa Healthcare  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McNamara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology, University of Iowa Healthcare  Iowa City Iowa 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