RESUMO
Ultrasound guidance may be a valuable adjunct for pediatric internal jugular vein catheterization. We previously reported a long-axis in plane technique, called the "three-step method", resulting in high success and a low complication rate by novice operators in adult patients. This is the first report of ultrasound-guided internal jugular vein catheterization (US-IJV) using the three-step method in pediatric patients. Fourteen junior residents underwent simulation training, and then participated in a clinical trial. They performed US-IJV in 14 pediatric patients with congenital heart disease before undergoing cardiac surgery under supervision of an experienced clinician. The overall success rate was 93 %, and all catheterizations were performed within two venipunctures. There were no complications associated with the procedure. The three-step method may facilitate pediatric US-IJV even by a novice operator during their first experience.
Assuntos
Cateterismo Periférico/métodos , Veias Jugulares/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Anestesia Geral , Procedimentos Cirúrgicos Cardíacos/métodos , Pré-Escolar , Competência Clínica , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Masculino , ManequinsRESUMO
UNLABELLED: A 7-year-old boy with Down syndrome developed severe acute respiratory distress syndrome after a respiratory infection with Mycoplasma pneumoniae with an unusually high agglutination titre (1:10240). Initially, mechanical ventilation and nitric oxide inhalation were used, but these did not improve the alveolar-arterial oxygen gradient. Extracorporeal membrane oxygenation for 152 h improved the lung condition. CONCLUSION: our case suggests that Mycoplasma pneumoniae should be considered as an aetiological agent in acute respiratory distress syndrome. Extracorporeal membrane oxygenation might have a valuable role in the management.