Echocardiogram - nā keiki

ʻO kahi echocardiogram kahi hoʻāʻo e hoʻohana i nā nalu kani e hana i nā kiʻi o ka puʻuwai. Hoʻohana ʻia ia me nā keiki e kōkua i ke kuhi ʻana i nā hemahema o ka puʻuwai e kū nei i ka wā hānau (congenital). ʻOi aku ka kikoʻī o ke kiʻi ma mua o kahi kiʻi x-ray maʻamau. ʻAʻole hōʻike kekahi echocardiogram i nā keiki i ka pāhawewe.

Hiki i ka mea mālama ola olakino kāu keiki ke hana i ka hoʻokolohua ma kahi keʻena haukapila, ma kahi haukapila, a i ʻole ma kahi kikowaena waho. Hana ʻia ʻo Echocardiography me nā keiki e moe ana a moe paha i ka ʻūhā o ko lākou makua. Hiki i kēia ala ke kōkua iā lākou e hōʻoluʻolu a hoʻomau.

No kēlā me kēia mau hoʻāʻo, hana kahi sonographer hoʻomaʻamaʻa i ka hōʻike. Unuhi kahi kauka lāʻau i nā hopena.

TRANSTHORACIC ECHOCARDIOGRAM (TTE)

ʻO TTE ke ʻano o ka echocardiogram a ka hapanui o nā keiki.

• Hoʻokomo ka sonographer i ka gel ma nā iwi aoao o ke keiki ma kahi o ka umauma ma kahi e puni ana ka puʻuwai. ʻO kahi mea paʻa lima, i kapa ʻia he transducer, kaomi ʻia ma ka gel ma ka umauma o ke keiki a kuhikuhi ʻia i ka puʻuwai. Hoʻokuʻu kēia mea i nā nalu kani kani pinepine.
• Hāpai ka transducer i ka leo o nā nalu kani e hoʻi mai ana mai ka puʻuwai a me nā kīʻaha koko.
• Hoʻololi ka mīkini echocardiography i kēia mau manaʻo i loko o nā kiʻi neʻe o ka puʻuwai. Paʻa ʻia i nā kiʻi paʻi.
• Hiki i nā kiʻi i ʻelua dimensional a i ʻole ʻekolu dimensional.
• ʻO ke kaʻina holoʻokoʻa holoʻokoʻa ma kahi o 20 a 40 mau minuke.

ʻAe ka hōʻike i ka mea hāʻawi e ʻike i ka pā ʻana o ka puʻuwai. Hōʻike ia i nā kiwikā o ka naʻau a me nā hanana ʻē aʻe.

I kekahi manawa, pale paha nā mumū, nā iwi ʻaoʻao, a i ʻole nā ​​ʻaʻa o ke kino i nā nalu kani mai ka hana ʻana i kahi kiʻi maopopo o ka puʻuwai. I kēia hihia, hiki i ka sonographer ke hoʻopili i kahi wai liʻiliʻi (ʻokoʻa kala) ma o ka IV e ʻike pono ai i ka naʻau o ka puʻuwai.

TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)

ʻO TEE kekahi ʻano echocardiogram a hiki i nā keiki ke loaʻa. Hana ʻia ka hoʻāʻo me ke keiki e moe ana ma lalo o ke kau.

• E hoʻopau ka sonographer i ka ʻāʻī o kāu keiki a hoʻokomo i kahi paipu liʻiliʻi i loko o ka paipu meaʻai a ke keiki (esophagus). Loaʻa i ka hopena o ka pahu i kahi pono hana e hoʻouna i nā nalu kani.
• Hōʻike nā nalu kani i nā kūkulu i ka puʻuwai a hōʻike ʻia ma ka pakuhi e like me nā kiʻi o ka puʻuwai a me nā kīʻaha koko.
• Ma muli o ka esophagus ma hope pono o ka puʻuwai, hoʻohana ʻia kēia ala e kiʻi i nā kiʻi o ka puʻuwai e akāka.

Hiki iā ʻoe ke hana i kēia mau kaʻina e hoʻomākaukau i kāu keiki ma mua o ke kaʻina hana.

• Mai ʻae i kāu keiki e ʻai a inu i kekahi mea ma mua o ka loaʻa ʻana o kahi TEE.
• Mai hoʻohana i kekahi kalima a me ka aila ma kāu keiki ma mua o ka hōʻike.
• E wehewehe i ka hōʻike i ke kikoʻī i nā keiki makua no laila maopopo lākou e noho mālie lākou i ka wā o ka hoʻāʻo.
• ʻO nā keiki ʻōpio ma lalo o 4 mau makahiki o ka makahiki e pono ai ka lāʻau (sedation) e kōkua iā lākou e noho mālie no nā kiʻi ʻoi aku ka maopopo.
• E hāʻawi i nā keiki ma mua o 4 i kahi mea pāʻani e paʻa a i ʻole e nānā iā lākou i nā wikiō e kōkua iā lākou e noho mālie a i ka wā o ka hoʻāʻo.

• Pono kāu keiki e hemo i kekahi kapa mai ka pūhaka a moe moe ma ka papa hōʻike.
• E kau ʻia nā uila i ka umauma o kāu keiki e kiaʻi ai i ka puʻuwai o ka naʻau.
• Hoʻopili ʻia kahi gel ma ka umauma o ke keiki. Anuanu paha ia. E kaomi ʻia kahi poʻo transducer ma luna o ka gel. ʻIke paha ke keiki i ke kaomi ma muli o ka transducer.
• Hiki paha i nā keiki ʻōpio ke hoʻomaha ʻole i ka wā o ka hoʻāʻo. Pono nā mākua e hoʻāʻo i ka noho mālie o ke keiki i ka wā o ka hoʻāʻo.

Hana ʻia kēia hoʻāʻo e nānā i ka hana, nā kīʻā puʻuwai, nā kīʻaha koko nui, a me nā keʻena o ka puʻuwai o kahi keiki mai waho o ke kino.

• He mau hōʻailona paha kāu keiki a he mau hōʻailona paha o nā pilikia puʻuwai.
• Pākuʻi paha kēia i ka hanu, ka ulu maikaʻi ʻole, ka pehu ʻana o ka wāwae, ka namunamu o ka puʻuwai, ke anuanu a puni ka lehelehe i ka wā e uē ana, nā ʻeha o ka umauma, ke kuni hiki ʻole ke wehewehe ʻia, a i ʻole nā ​​ʻōpala e ulu ana i kahi hōʻike moʻomeheu koko

Nui aʻe paha ka makaʻu o kāu keiki no nā pilikia puʻuwai ma muli o ka hoʻokolohua kūlohelohe a i ʻole nā ​​kīnā hānau ʻē aʻe e kū nei.

E ʻōlelo paha ka mea hāʻawi i kahi TEE inā:

• Maopopo ʻole ka TTE. ʻO nā hopena kūpono ʻole ma muli o ke ʻano o ka umauma o ke keiki, maʻi maʻi aʻa, a i ʻole ke kinona kino momona.
• Pono e nānā i kahi kikoʻī o ka puʻuwai i nā kikoʻī.

ʻO kahi hopena maʻamau ka manaʻo ʻaʻohe kīnā i nā kiwikā a i ʻole nā ​​keʻena a aia ka neʻe ʻana o ka paia o ka puʻuwai.

Hiki i kahi echocardiogram abnormal i ke keiki ke manaʻo i nā mea he nui. ʻO kekahi mau mea loaʻa ʻole he mea liʻiliʻi loa ia a ʻaʻole pilikia i nā pilikia nui. ʻO nā hōʻailona ʻē aʻe o ka maʻi puʻuwai koʻikoʻi. I kēia hihia, pono ke keiki i nā hoʻokolohua hou aku e ka loea. He mea nui loa e kamaʻilio e pili ana i nā hopena o ka echocardiogram me kāu mea hāʻawi i kāu keiki.

Hiki i ka echocardiogram ke kōkua i ke kuhi ʻana:

• Nā nohona puʻuwai maʻamau
• Nā ritme naʻau maʻamau
• Nā kīnā hānau o ka puʻuwai
• Hoʻonā (pericarditis) aiʻole ka wai i loko o ka ʻeke a puni ka puʻuwai (pericardial effusion)
• ʻO ka maʻi ma a i ʻole nā ​​puni o nā puʻupuʻu puʻuwai
• ʻO ke koko kiʻekiʻe i nā kīʻaha koko i nā akemāmā
• Pehea ka maikaʻi e hiki ai i ka puʻuwai ke pauma
• Kumu o kahi hāpule koko ma hope o ka hahau a i ʻole TIA

ʻAʻole ʻike ʻia ka TTE i nā keiki.

ʻO TEE kahi hana hoʻouka. Maliʻa paha aia kekahi mau pilikia me kēia hōʻike. E kamaʻilio me kāu mea hāʻawi e pili ana i nā pilikia e pili ana i kēia hōʻike.

Transthoracic echocardiogram (TTE) - nā keiki; Echocardiogram - transthoracic - keiki; ʻO Doppler ultrasound o ka puʻuwai - keiki; Echo nalu - keiki

Campbell RM, Douglas PS, Eidem BW, Lai WW, Lopez L, Sachdeva R. ACC / AAP / AHA / ASE / HRS / SCAI / SCCT / SCMR / SOPE 2014 hoʻohana kūpono kūpono no ka mua transthoracic echocardiography i ka maʻi maʻi pediatric cardiology: kahi hōʻike o ke Kulanui ʻAmelika o ka Cardiology kūpono e hoʻohana ai i nā Criteria Task Force, American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interencies, Society of Cardiovascular Compulated Tomography, Society for Cardiovascular Magnetic Resonance, a Ka Hui o ka Echocardiography Pediatric. ʻO J Am Coll Cardiol. 2014; 64 (19): 2039-2060. PMID: 25277848 pubmed.ncbi.nlm.nih.gov/25277848/.

ʻO Solomon SD, Wu JC, Gillam L, Bulwer B. Echocardiography. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua.Piladelapia, PA: Elsevier; 2019: chap 14.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 75.