Neonatal Hemodynamics

The Neonatal Hemodynamics team at Stead Family Children’s Hospital has undergone additional specialized fellowship training in advanced heart imaging (cardiac echocardiography) and physiology. Hemodynamics specialists assist the neonatology team in providing personalized and targeted care to medically complex patients in the NICU.

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Inside the womb, a baby depends on the oxygen it receives through blood flow from their mother. This helps the lungs, brain, and other organs develop even before the baby’s heart is ready to supply its own blood flow.

When a baby is born prematurely, it loses that critical support. This can cause issues with the development of the baby’s organs and puts them at immediate risk for serious conditions, such as bleeding in the brain. In many centers, it is difficult for doctors to recognize when there is heart failure or other major problems with the circulation.

Stead Family Children’s Hospital is one of the first U.S. hospitals to use an advanced imaging technique called neonatal hemodynamics to monitor the cardiovascular health of preterm and term babies to ensure safer and more accurate care.

How does neonatal hemodynamics work?

Neonatal hemodynamics uses a unique kind of ultrasound imaging called targeted neonatal echocardiography. This noninvasive method is performed by a specially trained physician and can rapidly capture dozens of images of a baby’s heart, valves, and blood vessels.

These images supply the most detailed information possible about a baby’s cardiovascular health. This information helps doctors monitor the baby’s lung development, check for any heart defects, assess their brain health, and create customized treatment plans designed to give these tiny, vulnerable patients a better chance at healthier lives. The Neonatal Hemodynamics team (includes 5 hemodynamic specialists and two trainees) has access to 3 echocardiography machines which allows immediate access to information which helps the medical team identify abnormal disease states quickly and better evaluate treatment efficacy.

Specialized care for babies in critical need

At Stead Family Children’s Hospital, all babies born before 27 weeks (about 6 months) undergo a neonatal hemodynamics exam on the first day after delivery. The sickest of those babies are examined even earlier. Published research from our Hemodynamics team has shown that survival rates have improved, and the risk of major brain bleeding, necrotizing enterocolitis and severe lung disease (BPD) has fallen since the introduction of hemodynamic screening as a standard of care. The outcomes for extremely premature infants are the best in the country.

Neonatal hemodynamics can also be used to help full-term newborns in critical condition, which can sometimes spare those babies from needing extracorporeal membrane oxygenation (ECMO)—a lifesaving, but invasive, partial lung-bypass system that helps supply oxygenated blood to a baby in need. This can be particularly valuable for patients with developmental diseases like congenital diaphragmatic hernia, who often would be treated with ECMO at other centers.

Dedicated and highly skilled providers

A neonatal hemodynamics service requires the expertise of physicians who are trained in neonatology and the cardiovascular system of premature babies. This is necessary for performing the specific ultrasound exam and for expertly interpreting the images captured.

At Stead Family Children’s Hospital, our fellowship-trained specialists in our neonatal hemodynamics program can provide this advanced care to babies in need. They also conduct research designed to further improve the care of preterm infants.

As a national leader in the use of neonatal hemodynamics, we’re a trusted source of expertise and training for other U.S. health facilities working to establish their own neonatal hemodynamics programs. In addition, doctors from all over the world visit our program to learn how to better provide care for the hearts of sick babies. The Iowa Hemodynamics program is the world leader.

Neonatal hemodynamics conditions treated

Patent ductus arteriosus (PDA)
Acute and chronic pulmonary hypertension
Pulmonary vascular disease
Heart dysfunction

Shock and acute hypotension
Systemic hypertension
Arterio-venous malformations (with specialized expertise in patients with Vein of Galen Malformation)
Congenital diaphragmatic hernia (CDH)

Learn more about becoming a hemodynamics specialist

Few places in the world offer fellowship level training focused entirely on hemodynamic care for the neonate. The University of Iowa program is the first of its kind in the United States.