scholarly journals The fourth thoracic vertebra as a radiographic landmark for the depth of right internal jugular vein catheterisation in infants: A retrospective study

2020 ◽  
Author(s):  
Guoliang Liu ◽  
Jianmin Zhang ◽  
Fang Wang ◽  
Heqi Liu
Keyword(s):  
Internal Jugular Vein ◽  
Chest Radiograph ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Jugular Vein ◽  
Congenital Heart Surgery ◽  
Thoracic Vertebra ◽  
Chest Radiographs ◽  
Significant Difference ◽  
Vertebral Bodies

Abstract Backgroundː The carina is considered a reliable marker for the depth of right internal jugular vein catheterisation in infants. However, the carina is not always visible on chest radiographs, whereas vertebral bodies usually are. We performed a retrospective analysis of routine post-procedural chest radiographs of infants who had undergone congenital heart surgery and required central venous catheterisation. We evaluated the possibility of using vertebral bodies as radiographic landmarks for the identification of the depth of right internal jugular vein catheterisation.Methodsː In total, 108 infants (aged 1–12 months) who underwent congenital heart surgery from the 1st of January, 2019, to the 30th of June, 2019, were included. We analysed the post-operative chest radiographs of those who underwent right internal jugular vein catheterisation and assessed the visibility of the carina and vertebral bodies, as well as their positional relationship.Resultsː In total, 95 children were enrolled; in 61 (64%) cases, the carina was visible on the chest radiograph, whereas in 34 (36%) cases, it was not visible. In all 95 (100%) cases, the vertebral bodies were clearly visible. There was a significant difference between the rate of visibility of the carina and vertebral bodies (P=0.01 P<0.05). The carina was located at the third thoracic vertebra in one case (2%) and at the fourth thoracic vertebra in 60 cases (98%). There was a significant difference in the position of the carina (P=0.01, P<0.05).Conclusionsː Most fourth thoracic vertebrae were at the same level as the carina on chest radiographs. The fourth thoracic vertebra, therefore, has potential as a radiographic landmark for the depth of right internal jugular vein catheterisation in infants when the position of the carina is not visible on the chest radiograph.

scholarly journals Outcomes of home mechanical ventilation with tracheostomy after congenital heart surgery

2021 ◽  
pp. 1-5
Author(s):  
Bahar Temur ◽  
İsmet E Emre ◽  
Selim Aydın ◽  
Mehmet A Önalan ◽  
Serdar Başgöze ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Median Duration ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Total Mortality ◽  
Congenital Heart Surgery ◽  
Home Mechanical Ventilation ◽  
Significant Difference

Abstract Objective: After congenital heart surgery, some patients may need long-term mechanical ventilation because of chronic respiratory failure. In this study, we analysed outcomes of the patients who need tracheostomy and home mechanical ventilation. Methods: Amongst 1343 patients who underwent congenital heart surgery between January, 2014 and June, 2018, 45 needed tracheostomy and HMV. The median age of these patients was 6.4 months (12 days–6.5 years). Nineteen patients underwent palliation while 26 patients underwent total repair. Post-operative diaphragm plication was performed in five patients (11%). Median duration of mechanical ventilation before tracheostomy was 32 days (8–154 days). The patients were followed up with their home ventilators in ward and at home. Mean follow-up time was 36.24 ± 11.61 months. Results: The median duration of ICU stay after tracheostomy was 27 days (range 2–93 days). Follow-up time in ward was median 30 days (2–156 days). A total of 12 patients (26.6%) were separated from the ventilator and underwent decannulation during hospital stay. Thirty-two patients (71.1%) were discharged home with home ventilator support. Of them, 15 patients (46.9%) were separated from the respiratory support in median of 6 weeks (1 week–11 months) and decannulations were performed. Total mortality was 31.1%. in which four patients are still HMV dependent. There was no significant difference for decannulation between total repair and palliation patients. Conclusion: HMV via tracheostomy is a useful option for the treatment of children who are dependent on long-term ventilation after congenital heart surgery although there are potential risks.

scholarly journals Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and Serological Parameters in Congenital Heart Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zhigang Qin ◽  
Younian Xu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Treatment Group ◽  
Cardiac Function ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Control Group ◽  
Muscle Rigidity ◽  
Significant Difference

In this study, we have investigated feasibility of remifentanil and sufentanil anesthesia in children with congenital heart disease surgery and its effects on cardiac function and serological parameters. For this purpose, a retrospective study was conducted on 120 children with congenital heart disease who underwent repair of ventricular septum or atrial septum in our hospital, specifically from January 2016 to January 2018, and 60 patients in each group were randomly divided into the control and treatment groups, respectively. The control group was anesthetized with sufentanil, and the treatment group was anesthetized with remifentanil. The heart function, serological indexes, and adverse reactions were observed and compared. We have observed that there was no significant difference in HR levels between these groups ( P > 0.05 ), but SDP and DBP values of the two groups were decreased after anesthetic induction ( P < 0.05 ). ACH, cortisol, and lactic acid in the treatment group were significantly lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of bradycardia, nausea and vomiting, hypotension, muscle rigidity, and respiratory depression in the treatment group was 16.67% lower than that in the control group ( P < 0.05 ). Remifentanil has less influence on hemodynamics and a better analgesic effect than fentanyl in inhibiting stress response in congenital heart surgery, which provides reference and basis for children congenital heart surgery.

scholarly journals The effect of pre-hospital discharge care program on mothers’ knowledge and reported practice for children with congenital heart surgery

2018 ◽  
Vol 8 (9) ◽  
pp. 122
Author(s):  
Fatma Ahmed Elsobky ◽  
Samah Abdalha Mohamed Amer ◽  
Ahlam Elahmady Mohamed Sarhan
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Program ◽  
Congenital Heart Surgery ◽  
Care Practice ◽  
Discharge Care ◽  
Significant Difference

Heart surgery in children is done to repair heart defects for a child born with congenital heart defects and heart diseases. The aim of the study was to evaluate the effect of pre-hospital discharge care program on mothers’ knowledge and reported practice regarding discharge care of children with congenital heart surgery. The study was conducted in the Heart Surgery Department at Abo-EL Riesh University Children Hospital. The sample included 30 mothers and their children that were available during the period of data collection. Three tools were used to collect data including: Tool I: Interviewing questioner sheet of the participants categorized into two parts. Part I and part II: Personal characteristics of the children and their mothers. Tool II: Assessment of mothers’ knowledge regarding care of children after congenital heart surgery. Tool III: Mother’s reported care practice checklist. Results: The results of the present study revealed that there was a highly significant difference in all items of care knowledge (activity, food, medication and follow-up) before, after immediately and after one month from discharge program with highly significant statistically (p < .001). Discharge program improve mothers’ knowledge and practice regarding care of their children after congenital heart surgery. Recommendations: Comprehensive, multidisciplinary discharge planning should deign early and should include the mothers and children contain education regarding congenital heart surgery care.

scholarly journals Comparison Between Effect of Head Positions on the Placement of Catheter in the Internal Jugular Vein

2009 ◽  
Vol 20 (2) ◽  
pp. 56-60
Author(s):  
Begum Marjan Mohol Choudhury ◽  
Ashia Ali ◽  
Mohiuddin Ahmed ◽  
AKM Shafiqur Rahman
Keyword(s):  
Internal Jugular Vein ◽  
Heart Surgery ◽  
Jugular Vein ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Head Rotation ◽  
Significant Difference ◽  
Extreme Degree ◽  
Head Positions ◽  
External Landmark

The position of the head of the patient play an important role in the ease and success of Right Internal Jugular Vein (RIJV) cannulation using external landmark-guided technique. Sixty patients undergoing open heart surgery for both acquired and congenital heart diseases were studied in three groups-neutral head position, head rotated to 20 degree and head rotated to 30 degree to the left for RIJV cannulation. The overall success rate irrespective of number of attempts and head positions in this study was 93.3%. Complications were a bit higher than in other studies. Available literature did not compare between different degree of position of head rotation. This study compared between these groups in terms of number of attempts required for RIJV cannulation, but no significant difference was found between or within the groups (P>0.05). From this study it can be proposed that, some degree of rotation (upto 20 degree) may be allowed to make landmark prominent but extreme degree of rotation which result in more number of attempts and complications is not desired.   Journal of BSA, Vol. 20, No. 2, July 2007 p.56-60

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