ABSTRACT
Hypoxemic respiratory failure in neonates is multifactorial and the underlying physiology can be difficult to discern based exclusively on clinical signs and bedside monitoring. Targeted neonatal echocardiography is a valuable tool that can provide mechanistic insights which may improve diagnostic precision and therapeutic decisions. There are multiple determinants of oxygenation, including heart function, ventilation-perfusion matching, the presence of shunts and the pulmonary vasculature. Interventions such as different mechanical ventilation strategies and use of medications create complex interactions between these factors. We hereby present a variety of clinical cases of hypoxemia in neonates with different underlying physiology mechanisms and the insights obtained from comprehensive assessment including targeted neonatal echocardiography.
