Echocardiographic-guided internal jugular venous cannulation in children with heart disease

Article Abstract:

Performing cannulation of the internal jugular vein under the guidance of real-time ultrasound imaging reduces the complication rate and increases success rates in children. The procedure is used to obtain biopsy specimens from heart transplant recipients and for certain heart disease diagnostic procedures. Blind attempts to enter the vein result in a 5% to 10% complication rate, including air in the chest, internal bleeding, carotid artery puncture, and nerve damage. The procedure was successfully performed on 25 patients 6 weeks old to 22 years old. The three instances of complications were related to general anesthesia, which is given to patients too young to cooperate. These were hoarseness, nausea and vomiting, and bronchospasm. All were transient. The procedure was stopped in two patients because of problems seen on the sonogram. Successful cannulations were subsequently performed on both patients, in one case with a minor modification of procedure.

Methods, Usage, Echocardiography, Cardiac catheterization, Heart catheterization

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Internal Medicine--Pediatrics Combined Residency Graduates

Article Abstract:

Most pediatric medicine graduates have become general practitioners, caring for both adults and children, and some 80% of them are board certified for both fields. This is significant because the United States health care system is strongly based in primary care. A survey was done of all graduates who completed pediatric medicine residency programs between 1986 and 1995. The survey was completed by 1,005 graduates of the total 1,482. Nearly 70% were practicing direct care of patients, most for patients of all ages, 85% managed patients who require hospitalization, and approximately 50% had a medical school appointment.

Statistical Data Included, Education, Surveys, Pediatricians, Physicians (General practice), General practitioners

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Efficacy of peripherally inserted central venous catheters placed in noncentral veins

Article Abstract:

Using catheters which are designed for central veins in children's noncentral veins seems equally effective, and safe. Many times, for one reason or another, peripherally inserted central venous catheters (PICC) must be used in noncentral veins. In studying 587 PICCs, of which 39 were placed in noncentral veins, the rates of infection, accidental dislodgment and occlusion were similar. The PICCs in central veins had significantly longer duration, but therapy completion rates were similar.

Health aspects, Equipment and supplies, Intravenous catheterization, Catheters

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