{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:11:08Z","timestamp":1774663868933,"version":"3.50.1"},"reference-count":26,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1998,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>AIMS<\/jats:title>\n                  <jats:p>To examine the hypothesis that right to left shunting occurs mainly in the lungs rather than through the fetal channels in neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Thirty two term babies requiring over 70% oxygen had daily colour Doppler echocardiograms until recovery. Measurements included left ventricular fractional shortening, right and left ventricular outputs, colour and pulsed Doppler ductal and atrial shunting and systolic pulmonary artery pressure (SPAP) derived from ductal shunt or tricuspid incompetence velocities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The babies were retrospectively classified into a respiratory group (n=19) and a persistent pulmonary hypertension (PPHN) group (n=13) on the basis of clinical history and radiology. At the initial echocardiogram, just 50% of babies had suprasystemic SPAP. Despite better oxygenation, more of the PPHN group had suprasystemic PAP (85% <jats:italic>vs<\/jats:italic> 26%). A correlation between SPAP and Oxygen index (OI) was present only in the respiratory group (r=0.7). Low ventricular outputs (&lt;150 ml\/kg\/min) were common in both groups (53% and 79%). The respiratory group had more closed ducts (47%<jats:italic>vs<\/jats:italic> 0%) and those ducts which were patent were more constricted (1.75mm <jats:italic>vs<\/jats:italic> 2.6 mm). Pure right to left ductal shunts were seen in just 15% and pure right to left atrial shunts in just 6% of all babies. The serial echocardiograms showed that SPAP fell and ducts closed well before oxygenation improved. Ventricular outputs increased with age in both groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Apart from early on in the sickest babies with a primarily respiratory diagnosis and the babies with primary PPHN, most right to left shunting occurred at an intrapulmonary level.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.78.2.f105","type":"journal-article","created":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T11:39:16Z","timestamp":1239190756000},"page":"F105-F111","source":"Crossref","is-referenced-by-count":54,"title":["Range of echocardiographic findings in term neonates with high oxygen requirements"],"prefix":"10.1136","volume":"78","author":[{"given":"Nick","family":"Evans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Kluckow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Currie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1998,3,1]]},"reference":[{"key":"2025090514395595000_78.2.F105.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70197-4"},{"key":"2025090514395595000_78.2.F105.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80966-7"},{"key":"2025090514395595000_78.2.F105.3","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(92)90102-D"},{"key":"2025090514395595000_78.2.F105.4","doi-asserted-by":"crossref","first-page":"F26","DOI":"10.1136\/fn.74.1.F26","article-title":"Haemodynamic features at presentation in persistent pulmonary hypertension of the newborn and outcome.","volume":"74","author":"Skinner","year":"1996","journal-title":"Arch Dis Child"},{"key":"2025090514395595000_78.2.F105.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.6.1072"},{"key":"2025090514395595000_78.2.F105.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(87)90363-8"},{"key":"2025090514395595000_78.2.F105.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF02238491"},{"key":"2025090514395595000_78.2.F105.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(87)80047-5"},{"key":"2025090514395595000_78.2.F105.9","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.1_Spec_No.6"},{"key":"2025090514395595000_78.2.F105.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70078-8"},{"key":"2025090514395595000_78.2.F105.11","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0735-1097(10)80076-2","article-title":"Doppler echocardiographic measurement of pulmonary artery pressure from ductal Doppler velocities in the newborn.","volume":"15","author":"Musewe","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"2025090514395595000_78.2.F105.12","doi-asserted-by":"publisher","DOI":"10.1136\/adc.69.2.216"},{"key":"2025090514395595000_78.2.F105.13","doi-asserted-by":"publisher","DOI":"10.1136\/adc.67.4_Spec_No.374"},{"key":"2025090514395595000_78.2.F105.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(94)70079-6"},{"key":"2025090514395595000_78.2.F105.15","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.65.1.41"},{"key":"2025090514395595000_78.2.F105.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82060-8"},{"key":"2025090514395595000_78.2.F105.17","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1542\/peds.76.5.829","article-title":"Pulsed Doppler determinations of cardiac output in neonates: normal standards for clinical use.","volume":"76","author":"Walther","year":"1985","journal-title":"Pediatrics"},{"key":"2025090514395595000_78.2.F105.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(73)80472-X"},{"key":"2025090514395595000_78.2.F105.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(83)80573-3"},{"key":"2025090514395595000_78.2.F105.20","doi-asserted-by":"publisher","DOI":"10.1378\/chest.90.1.74"},{"key":"2025090514395595000_78.2.F105.21","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1152\/jappl.1993.75.2.704","article-title":"Perfusion of alveolar septa in isolated rat lungs in zone 1.","volume":"75","author":"Conhaim","year":"1993","journal-title":"J Appl Physiol"},{"key":"2025090514395595000_78.2.F105.22","unstructured":"Hill E P Power GG Longo LD West JB , eds (1977) Kinetics of O2 and CO2 exchange. 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