RESUMO
OBJECTIVE: We wished to determine serum lidocaine concentrations after subcutaneous injection during cardiac catheterization. METHOD: Serum lidocaine concentrations were measured in 50 patients during catheterization. RESULTS: Serum concentration was linearly related to dose per kilogram of body weight. Lidocaine concentrations were therapeutic in 38% of patients. CONCLUSION: Lidocaine dose must be considered when the drug is used for local anesthesia in children.
Assuntos
Anestésicos Locais/farmacocinética , Cateterismo Cardíaco , Lidocaína/sangue , Anestésicos Locais/administração & dosagem , Criança , Pré-Escolar , Humanos , Injeções Subcutâneas , Lidocaína/administração & dosagem , Lidocaína/farmacocinéticaAssuntos
Ecocardiografia/métodos , Tetralogia de Fallot/diagnóstico , Adolescente , Criança , Pré-Escolar , Estudos de Avaliação como Assunto , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Lactente , Recém-Nascido , Contração Miocárdica , Radiografia , Tetralogia de Fallot/fisiopatologiaAssuntos
Ecocardiografia , Insuficiência da Valva Pulmonar/diagnóstico , Criança , Humanos , MasculinoRESUMO
In this review, we demonstrate the normal patterns of flow and some quantitative applications of Doppler echocardiography combined with two-dimensional imaging. Flow information can be accurately measured and valve gradient calculations can be made in patients with stenotic diseases. Further corroborative work in this area is necessary before definitive statements can be made, but this appears to be a promising noninvasive technique which can be applied at the bedside or in an ambulatory setting with a fair degree of confidence.
Assuntos
Ecocardiografia , Função Atrial , Circulação Sanguínea , Velocidade do Fluxo Sanguíneo , Efeito Doppler , Humanos , Contração Miocárdica , Função VentricularRESUMO
Seven patients with angiographically proven aneurysm of the membranous interventricular septum associated with membranous ventricular septal defect were studied by two-dimensional echocardiography. In all patients a curvilinear, dome-shaped echo arising from the upper ventricular septum and bulging toward the right ventricular cavity in systole was identified. This finding was detected in all long axis views (7/7), and 4/7 short axis views, in 4/6 apex four chamber views and in 3/6 subcostal four chamber views. Two-dimensional echocardiographic studies in forty patients with angiographically proven membranous ventricular septal defect, but not septal aneurysm, revealed only one case with similar findings, suggesting ventricular septal aneurysm, in the long axis and apex four chamber views. We conclude that two-dimensional echocardiographic imaging of a curvilinear echo in the proximal interventricular septum, bulging toward the right ventricle in systole and visualized in different planes, is very suggestive of aneurysm of the membranous ventricular septum. Two-dimensional echocardiography appears to have acceptable specificity for the diagnosis of aneurysms of the ventricular septum.
Assuntos
Ecocardiografia , Aneurisma Cardíaco/diagnóstico , Septos Cardíacos , Criança , Pré-Escolar , Aneurisma Cardíaco/etiologia , Comunicação Interventricular/complicações , Ventrículos do Coração , Humanos , LactenteRESUMO
Suprasternal range-gated pulsed Doppler echocardiography was used to evaluate surgical shunt patency in children with cyanotic congenital heart disease and right ventricular outflow obstruction following systemic artery to pulmonary artery anastomoses. Normal patients had laminar Doppler auditory signals and time interval histogram flow patterns because right pulmonary artery turbulence was not present during systole or diastole. Patients with pulmonary valvar stenosis had turbulence during systole only. In all nine postoperative patients with surgical shunts, turbulent systolic and diastolic time interval histograms and abnormal auditory signals were present. A typical shunt murmur was not audible to auscultation in six of the postsurgical patients at the time of the study. Suprasternal range-gated pulsed Doppler echocardiography affords an accurate, safe and simple noninvasive bedside means for confirming shunt patency in patients who have undergone surgical systemic artery to pulmonary artery anastomoses.
Assuntos
Ecocardiografia , Cardiopatias Congênitas/cirurgia , Monitorização Fisiológica/métodos , Artéria Pulmonar/cirurgia , Adolescente , Criança , Pré-Escolar , Auscultação Cardíaca , Humanos , Lactente , Estenose da Valva Pulmonar/cirurgiaRESUMO
Echocardiography is a new noninvasive tool which provides real-time motion visualization of intracardiac structures for the evaluation of anatomy and physiology in patients with congenital heart disease. This paper is presented to acquaint the pediatrician with the utilization and potential of this technique as practiced by pediatric cardiologists. A discussion of principles of physics and instrumentation in echocardiography is followed by a description of normal echocardiographic anatomy. Specific malformations which can be diagnosed reliably by this technique include: hypoplastic left heart syndrome, transposition of the great vessels, tetralogy of Fallot, idiopathic hypertrophic subaortic stenosis, mitral valve prolapse, and pericardial effusion. In addition, the evaluation of patients with atrial septal defects and patent ductus arteriosus is discussed. New advances in instrumentation and their potential impact in pediatric cardiology are reviewed.