Vascular Medicine Branch
and research nurses from inpatient unit 5SE-S
Research nurse, Marlene Peters-Lawrence, taking a patient phone call.
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Welcome to the Vascular Medicine Branch of the NHLBI
The researchers and staff of the National Heart, Lung, and Blood Institute and the Clinical Center welcome you.
The medical, nursing, and supportive care teams of the Vascular Medicine Branch (VMB) invite you to learn more about our dedicated team. We specialize in treating vascular disorders primarily associated with sickle cell disease and other hemolytic conditions.
Mission Statement
Working together to find innovative therapies through scientific discovery
Research Goals
- Studying the prevalence and causes of pulmonary hypertension (high blood pressure in the lungs) in patients with sickle cell disease.
- Evaluating new treatments for patients with sickle cell disease, targeting:
- Pulmonary hypertension (high blood pressure in the lungs)
- Blood flow
- Inflammation
- Vaso-occlusive pain crisis
- Acute chest syndrome
- Study the reactions of nitric oxide in human blood.
- Using genomics and gene expression microarray technologies to understand sickle cell disease pathogenesis and to develop prognostic models.
As you journey with us towards the discovery of new therapies for sickle cell disease and pulmonary hypertension you will be seen in our Outpatient Clinic, OP7, and Inpatient Care Unit, 5 South-East South or the Pediatric Clinic. Please see the Hematology
Welcome page for information about the clinic which we share with Hematology and Cardiology and information/pictures of the inpatient unit.
For information regarding our actively enrolling clinical research studies visit the NHLBI Patient Recruitment website.
For more information on sickle cell disease, visit the Sickle Cell link under the NHLBI website. Various organizations, such as the Sickle Cell Disease Association of America (SCDAA) and other sickle cell centers, are great resources to provide the latest information on sickle cell disease and help identify local support groups.
The NIH Sickle Cell Support Group meets monthly to discuss topics affecting individuals who have sickle cell disease.
 NIH Social Worker Ihsan Rogers, LICSW
Ihsan Rogers is a licensed social worker who facilitates these meetings and also helps to address multiple needs to both our inpatients and outpatients. To find out more information about NIH's Social Work Department, please visit their website.
TESTING
During your screening, treatment, and follow-up care you will receive a variety of tests to evaluate your progress. Frequently scheduled tests include blood and urine lab work, MRI, chest X-ray, CT scan, echocardiogram, exercise tests, overnight sleep study, pulmonary function testing, six minute walk and right heart catherterization. While you are an outpatient, your protocol coordinator will assist you in scheduling required tests.
CARDIAC MRI
(Magnetic Resonance Imaging)
Why is this test performed?
MRI is a non-invasive procedure that uses powerful magnets and radio waves to construct pictures of the heart. It does this without use of radiation.
MRI provides detailed pictures of the heart and blood vessels and can tell the difference between tissues and moving blood. This test is done to rule out any other disease that would cause pulmonary hypertension. MRI is excellent at showing the heart from many different views. It is also useful because it is a non-invasive way to study heart function.
 An MRI scanner How is this test performed?
You will be asked to lie on a narrow table which slides into a tunnel like tube within the scanner. A technologist will operate the machine and observe you during the entire study from an adjacent room. There is an intercom inside the scanner so you will be able to communicate with the staff throughout the scan.
When the scanning starts, you will hear thumping sounds. These sounds are made by the magnetic fields. From time to time during the scan you will be asked to hold your breath for 10-20 seconds. This will help the pictures come out clearer. This scan will last between 1-2 hours.
How will this test feel?
There is no pain associated with a MRI. Most patients feel no side effects from the MRI. Some patients may feel twitching in their fingers and toes. This is caused by the magnetic field. The most common complaint during MRI is discomfort from lying on the table, which may feel hard and cold. You can use a blanket or pillow to help with that discomfort. Also, some patients complain of feeling claustrophobic from being inside the scanner. You will be monitored closely throughout the test and can speak through the intercom if you have concerns.
What are the risks to this test?
There have not been any documented side effects to MRI.
Special considerations
You will be asked to fill out a safety questionnaire. This questionnaire helps us find out if there are safety reasons you should not have a cardiac MRI. Because of the strong magnets, certain metallic objects are not allowed in the room.
Items such as jewelry, watches, credit cards and hearing aids can be damaged. Pins, hairpins, zippers can distort the images. Removable dental work should be taken out right before the test. Pens, pocketknives and eyeglasses can become dangerous projectiles when the magnet is activated and should not accompany the patient into the scanner.
Also, the strong magnetic fields can disrupt the action of implanted metallic objects. Therefore, people with any type of implanted metal objects may be advised not to have the MRI. Examples of such devices are: cardiac pacemakers or defibrillators, inner ear implants, brain aneurysm clips, older vascular stents, and recently placed artificial joints.
A hospital gown or sweat pants is the best attire for the procedure because they lack metal.
CHEST X-RAY
Why is this test performed?
A chest X ray takes pictures of the chest, heart, lungs, large arteries, ribs and the diaphragm. A chest X ray is ordered when the patient has symptoms (cough, coughing up blood, chest pain etc.) or when lung disease is suspected. Pulmonary hypertension is considered a lung disease. This study looks at your chest X-ray to see if there is scarring in your lungs. Also, sometimes with high blood pressure in the lungs, your pulmonary artery will appear slightly larger than a person without pulmonary hypertension. Chest X-ray is also useful for determining if there is an infection in the lung (pneumonia).
How is this test performed?
The test is performed on the first floor in the radiology department. Two pictures are taken. One view will be taken from back to front and the other is taken from the side. You will stand in front of the X-ray machine. The technician will ask you to take a deep breath in and hold it for a second while he/she snaps the picture.
How will this test feel?
There is no discomfort associated with a chest X-Ray.
What are the risks to this test?
There is a low radiation exposure. For this study, we will be keeping track of your exposure to radiation from all tests. There is a group at NIH that monitors all safety aspects of studies. This group reviewed the protocol before it was approved to be sure that the cumulative dose of radiation from all the tests is safe.
CT SCAN: CHEST
(Computerized Tomography)
Why is this test performed?
A chest CT is done to examine the structures inside the chest. This test may show many disorders of the heart, lung or chest area. This test is important for this study to rule out other diseases or disorders in the chest that would also cause pulmonary hypertension (high blood pressure in the lungs).
How is this test performed?
You will be asked to lie on a narrow table that slides into the center of a scanner. The scanner looks like an archway. You will be asked to lie still because motion causes blurred pictures (like a regular picture camera). The tech performing the study will also give you instructions through an intercom, like ‘take a deep breath in and hold it’, ‘breathe out,’ ‘lie still’, etc.. As the exam takes place, the table will slowly advance through the scanner.
You may be asked to remove any jewelry (necklaces) and wear a hospital gown. If you are female, you will be asked to remove any brassiere’s that have metal wires. That is because metal objects are very dense and the scanner X-ray beam has difficulty passing through them.
The scan should take approximately 15 minutes to complete. You will not be receiving contrast for the test.
How will this test feel?
X-rays are painless. The primary discomfort is from having to lie still on the table.
What are the risks to this test?
There is an exposure to radiation from the CT test X-rays. CT tests are monitored and regulated so that they provide the smallest amount of radiation possible. CT scans provide low levels of radiation. For this study, we will be keeping track of your exposures to radiation from all tests. There is a group at NIH that monitors all safety aspects of studies. This group reviewed the protocol before it was approved to be sure that the cumulative dose of radiation from all the tests is safe.
ECHOCARDIOGRAM
Why is this test performed?
An echocardiogram is an ultrasound of the heart. It is used to evaluate the chambers and valves of the heart in a non-invasive way. Many different cardiac and pulmonary conditions can be found with ultrasound. This study looks at the echocardiogram to estimate the blood pressure in the lungs by measuring the amount of backflow from your tricuspid valve into the right atrium. The tricuspid valve is the doorway for blood between the right atrium and the right ventricle. The pulmonary artery carries oxygen poor blood from the right ventricle to the lungs to pick up more oxygen. Usually, the pressure in the right ventricle is higher than in the pulmonary artery and lungs so that the blood flows forward to the lungs easily. When the blood pressure in the lungs is high, it causes the backflow of some blood back into through the tricuspid valve. The ultrasound (echo) is able to see that blood backing up. The speed with which it is pushed through the tricuspid valve is called the "tricuspid regurgitant jet velocity". This is the measurement we use to estimate the pressure in your lungs.
 Patient getting an
echocardiogram. How is this test performed?
A trained technician will perform the test. A transducer (an instrument that transmits high-frequency sound waves) is placed on your chest near your heart. The transducer picks up the echo’s of the waves and transmits them into an electrical impulse and relays it to an echo machine where it is displayed and recorded. The tech may ask you to switch positions or breathe a certain way.
How will this test feel?
Echocardiograms are painless. Conductive gel is placed on your chest. The transducer is placed directly on your chest.
What are the risks to this test?
There are no known risks associated with this test.
EXERCISE TEST
Why is this test performed?
This test shows us your body’s response to exercise. This test will measure your lung’s ability to tolerate exercise. When you exercise, your body demands more oxygen. This test will measure the oxygen consumption and carbon dioxide production of your lungs.
How is this test performed?
You will be riding a stationary bicycle during this test. You will have a period of warm up at the beginning and cool down at the end. You will be asked to pedal on the bike as the technician gradually increases the intensity level on the bicycle. You will continue pedaling until you are too tired to continue. Many things will be monitored during the exercise.
You will have electrodes (conductive stickers) placed on your chest.  These will be attached to a cord that records the electrical activity of your heart. Your blood pressure will be taken a few times during the study by a cuff on your upper arm. These measurements tell us how your heart responds to exercise. We also monitor how your lungs respond to exercise. You will wear a mask which will measure the amount of oxygen you breathe in and the amount of carbon dioxide you breathe out. This tells us how well your body responds to the demand for more oxygen during exercise and how efficiently it uses that oxygen.
How will this test feel and what are the risks?
There should be no pain experienced during this test. You may feel tired from riding the bike. You could become short of breath, feel dizzy or have chest pain while exercising. Please tell the technician if you experience any discomfort or pains. There will be a physician in the room to monitor you during the test. There have been many tests like this done with patients with sickle cell anemia with no reported problems. This test is also done with patients with pulmonary hypertension without report of problems. Because you have sickle cell disease and pulmonary hypertension it is possible that you could experience an increase in the lung pressures during the test. This could cause an abnormal heart rhythm. We monitor for this with the electrodes on your chest and the blood pressure measurements.
OVERNIGHT SLEEP STUDY
(Overnight Pulse Oximetry)
Why is this test performed?
This test is done to monitor your oxygenation during sleep. Oxygen levels naturally decrease during sleep. This test is done to see if your oxygen levels stay within a normal range while you are asleep.
How is this test performed?
A pulse oximeter is a portable, bedside monitor that is electrically powered or battery operated. The pulse oximeter, ‘pulse ox’, estimates arterial oxygen saturation (amount of blood in the arteries filled with oxygen) by using wavelengths of light. The pulse ox will digitally display your heart rate and the oxygen saturation as a percentage. For example: pulse rate: 72; O2 sat: 96%.
This monitor is attached by a little probe that slips onto one of your fingers. You will see a little red light on the sensor. The probe will sit snugly, but not tightly, on your finger. The pulse ox will be attached from 9 pm until about 7 am the next morning and make continuous reading while you sleep. There will not be any alarms set so your sleep should not be disturbed. This will give the team a good idea of how well your blood gets oxygen while you sleep.
How will this test feel?
This test is painless. The probe may be annoying to keep on your finger but will not cause pain.
What are the risks to this test?
There are no known risks associated with this test.
PULMONARY FUNCTION TESTS
Why are these tests performed?
Pulmonary function tests (PFT) measure how well the lungs take in and exhale air. They also check how well the lungs transfer oxygen into the blood. PFT's consist of spirometry test, lung volume measurement and diffusion capacity. Spirometry looks at how well you exhale air. Lung volume measurement looks at how much air you can breathe in. Diffusion capacity looks at how well your lungs transfer oxygen from the air to the bloodstream. Different diseases are identified by which one of the tests is abnormal. The results not only identify what kind of lung disease a person has but also the degree of dysfunction.
How are these tests performed?
With spirometry, you breathe into a mouthpiece that is connected to an instrument called a spirometer. The spirometer records the amount of air and the rate of air that is breathed in and out over a specific period of time. The technician performing the test will give you directions on how to breathe. (Ex: normal quiet breathing, deep breaths in and blow out, etc.)
Lung volumes can be performed two ways. The most accurate way is for you to sit in a box that resembles a telephone booth (a plesmythograph) and breathe in and out against a mouthpiece. Changes in pressure inside the box allow determination of the lung volume.
Measuring a patient's lung volume
in a special plumonary funtion booth.
The diffusion capacity is measured when you breathe carbon monoxide for a short time (usually one breath). The concentration of carbon monoxide in the exhaled air is then measured. The difference in the amount of carbon monoxide inhaled and the amount exhaled allows the estimation of how rapidly gas can travel from the lungs into the blood.
Methacholine challenge test is also done to rule out asthma. Methacholine is an agent that, when inhaled, causes the airways to narrow if asthma is present. The methacholine is given at increasingly higher doses throughout the test. There are medications that can be given to reverse the effects of the methacholine, therefore it is very safe.
How will these tests feel?
These procedures are painless. You will be given adequate periods to rest during the testing. Because the test involves some forced breathing and rapid breathing, you may experience temporary shortness of breath or lightheadedness. The technician will be with you the entire time of testing. If these symptoms occur during your test and are intolerable, tell the technician. The technician will explain the procedure to you also.
What are the risks to this test?
The risk is minimal for most people. This test should not be performed if you have recently suffered a heart attack or were told you have acute coronary insufficiency.
PULMONARY VENTILATION/PERFUSION SCAN
(VQ SCAN)
Why is this test performed?
This is a nuclear scan test using inhaled and injected radioactive material called radioisotopes. These radioisotopes help measure breathing (ventilation) and circulation (perfusion) in all areas of the lungs. The ventilation part is used to evaluate the ability to aerate all portions of the lungs. The perfusion scan measures the supply of blood through the lungs. This test is done to check for pulmonary embolus, a blood clot in the lung, or any other abnormal circulation in the lungs that could contribute to high lung pressures.
How is this test performed?
These are two tests that are usually performed together. The perfusion scan is done by injecting radioactive albumin (a protein) into a vein through an IV. The patient is then placed on a movable table that is positioned under the arm of the scanner. The lungs are scanned to detect the location of the radioactive particles as blood flows through the lungs.
The ventilation scan is performed by scanning the lungs while after you inhale radioactive gas (Xenon-133) by a mask. You will be asked to hold your breath for a few seconds and then to breathe normally. Your lungs will be scanned while you breathe through the mask.
How will this test feel?
You may feel a sharp prick during the insertion of the IV. The table may be uncomfortable or feel cold. The mask used occasionally causes a small amount of people to have a feeling of claustrophobia.
What are the risks to this test?
The radiation exposure risk is the same as with regular X-rays. There is a small radiation exposure from the radioisotopes. The radioisotopes are usually short lived, with almost all the radiation gone in a few days. No radiation is emitted from the scanner. For this study, we will be keeping track of your exposures to radiation from all tests. There is a group at NIH that monitors all safety aspects of studies. This group reviewed the protocol before it was approved to be sure that the cumulative dose of radiation from all the tests is safe.
There is the possibility for an allergic reaction to the medication injected (albumin). If you are allergic to eggs you should not have this test. There have been four case reports of death after lung scanning in the world literature, the last was in 1975. All of those deaths occurred after injection of the albumin at much higher doses and particle numbers than we use in this study. Patients with high blood pressure in the lungs routinely get these scans and no deaths have been reported. We have a radiation pharmacist that specially prepares the lowest dose of radiation possible for our study.
SIX MINUTE WALK
Why is this test performed?
The six-minute walk is a tool used as a tool to evaluate the functional exercise level of patients with moderate to severe heart or lung disease. In our study, it is used as a baseline of your exercise tolerance. It is also used after a new treatment is started to see if that chosen therapy is helping.
 Respiratory Therapist, Kevin Cole, watches as a patient does her six minute walk test. How is this test performed?
The walk is done on a flat surface with a staff member measuring the distance walked. You walk at your own pace as far as you can in a six-minute period. The distance you walk is recorded and any symptoms or pain you have is noted. The idea is that the walk gives a good reflection of how well you tolerate doing your activities of daily living. Your blood pressure, pulse rate and oxygen saturation will be measured before and after the walk.
How will this test feel?
That depends on you. This test measures your response to exercise, at your own pace. Some people have no problems at all. Others may have shortness of breath, chest pains, leg pains, etc. You may stop the test at any time if you are not feeling up to it or if a problem occurs during the walk.
What are the risks to this test?
We will stop the test immediately for any of the following: chest pain, intolerable shortness of breath, leg cramps, staggering, excessive sweating or pale or ashen appearance. The staff member performing the walk is trained to respond to any of the above named events, if necessary.
RIGHT HEART CATHETERIZATION
("Swann-Ganz")
Why is this test performed?
This procedure is done to diagnose certain cardiac and pulmonary diseases. A right heart catheterization is considered the 'gold standard' test to diagnose pulmonary hypertension. That means it is established by the medical community as the best test available to diagnose pulmonary hypertension.
 Cath Lab at NIH How is this test performed?
This test involves passing a catheter (a thin flexible tube) into the right side of the heart. This thin tube is inserted through a vein in your neck. The insertion of the catheter is similar to the insertion of a regular IV (in your arm) except that this catheter is a little bigger and longer. Here are some of the key things to know about the catheter placement.
Dr. Cuttica, a Critical Care Fellow,
is preparing to perform a right heart
catheterization.
Sedation: Before the insertion starts, you will receive IV medication to help you relax and for any pain you are having. We usually use versed and fentanyl. Fentanyl is a narcotic similar to morphine, but stronger. Versed is a benzodiazapine sedative. This drug is nice because it provides a calming sensation AND will cause you to lose your memory of the procedure. There will be an ICU nurse with you the entire time in addition to the doctors that are placing the catheter.
Numbing Medicine: The doctor will start the insertion by giving you a little needle around the area of insertion that contains numbing medicine. People that have had this little needle with the numbing medicine say it feels like a bee sting. This drug is called lidocaine. It works like the medicine the dentist gives you to numb your gums before dental work. This lidocaine will numb the area so that you do not feel the catheter insertion. You will not feel any sharp pain. If you do, let the doctor know and he can give you more lidocaine. However, you will feel pressure as the doctor inserts the catheter. It will probably feel weird to you but it should not be pain.
Drapes: The doctors that are inserting the catheter (also called 'line') will be wearing sterile gowns, masks and gloves. This is to be extra careful in preventing an infection from putting the line in. This is a standard for putting in any IV that is in the neck, not just for right heart catherizations. Also, you will have a sterile towel draped over the neck and face area. This is done to keep only the site exposed after the doctor has cleaned and prepped the area. This may be a little strange because your face may be under the towel. Do not worry, though, the doctors and nurses are very close and will be able to hear you if you speak. Also, we often will hold the patient's hand during the procedure so that they know that someone is there with them besides the doctor inserting the line.
Line insertion: After the area is sterile and numb, the doctor will insert the catheter. This catheter will go through the vein in your neck on the right and thread down the natural blood pathway to the right side of the heart. The tip of the catheter will sit in the lung artery.
X-Ray: After the catheter is inserted, a chest X ray will be taken at the bedside to make sure it is sitting in the correct place in your right ventricle.
Taping: The part of the catheter that sits outside the body is long and bulky. The nurse or doctor will make sure that it is taped securely.
Uses: this catheter directly measures the pressures in your heart and can tell us by using the measurements of the left side of the heart, what the pressures in your lung are. Also, this catheter is like a big IV. There are 3 places on the line that we can administer IV medications and fluids and 4 places from which we can draw blood. During the study we will be drawing blood from the line frequently. You will not feel anything when we draw the blood.
Risks: see detailed explanations.
Sounds scary, what are the risks?
Believe it or not, right heart catheterization is a safe procedure. In fact, complications are so rare that it may be done on an outpatient basis. If you were having this done strictly for diagnosing pulmonary hypertension (not as part of our study) it would most likely be done as an outpatient.
Bruising: The most common risk is a 'hematoma', or bruise, at the insertion site. You may have a sore spot after the catheter comes out and you may have a lump or visible bruise. .
Pneumothorax: Pneumothorax is the technical name for puncturing the lung. There is a 3 in 1000 risk that your lung may be punctured during the procedure. We routinely check for this after the procedure by taking a chest X-ray. The puncture in the lung causes air to build up in the pleural space (lining around the lungs). This air collection changes the pressure gradient within the lungs. That change causes the lung to ‘collapse’ because the air coming in through the puncture site takes up all the space that the lungs normally occupy. Think of it as the bad air coming in from the puncture site squishing out the good air from the lung. The lung just cannot fill up properly without enough space. If your lung is punctured, we would need to insert a tube in your chest to let the air out of the pleural space. This lets the good air flow back into the right space, the lungs. The tube would stay in for a few days until the puncture site heals.
Arrhythmias: Arrhythmia is the technical name for abnormal heart beats. There is less than 1 in 100 chance of causing abnormal beats. These beats usually stop when the catheter is removed. Some abnormal beats can be life threatening. We are monitoring your heart beat during the entire procedure and as long as the catheter is in place. If you were to have a life threatening arrhythmia, we would remove the catheter immediately. The catheter can be removed in a matter of seconds. Also, the ICU is stocked with emergency medications that treat abnormal beats. These medications are readily available for use in that type of situation.
Cardiac tamponade: If there is an injury to the right side of the heart, blood could leak out. The blood would leak into the pericardial sac (the fluid filled pouch that surrounds the heart to help it contract smoothly). The sac can fill up with blood and squeeze the heart. The sac fills up and takes up the space that the heart normally uses when it fills with blood prior to each heartbeat. This will make your blood pressure drop. If this happens, we insert a needle into that sac to drain the blood. The chance of this happening is small (1 in 500).
Pulmonary artery damage: A very rare complication is tearing of the pulmonary artery (the big blood vessel that carries oxygen poor blood from the right ventricle to the lungs). This complication could cause death. This has never occurred at the NIH and has only been reported very rarely in the literature.
Complications and the NIH: Many of these complications could be very serious and theoretically lead to death if the treatments are ineffective. At NIH, we have NEVER had a death related to a pulmonary artery catheter placement in the intensive care unit over the last 10 years. There are more than 100 catheter placements done per year.
We will discuss this process with you at length. You will have plenty of time to
to discuss questions and concerns. Please ask anything that is unclear or worrisome to you!
NITRIC OXIDE (NO)
Description
Nitric oxide is an inhaled medication that belongs to a group of medications that are called nitro vasodilators. It is a colorless, odorless gas. This gas is naturally produced by the lining of the cells of healthy arteries. It helps keep the arteries dilated.
It works by vasodilating (opening) the pulmonary blood vessels. The NO is inhaled through a nasal cannula or a mask. It is carried by breathing to your lungs where it crosses into the blood vessels of the lungs. There it will dilate, or open up, those vessels. This makes the blood flow through the pulmonary vessels easier, making the blood pressure in the lungs lower. We give this medication for 10 minutes or so to test your lungs responsiveness to this type of medication. This gives us a hint of how you might respond to medications that treat pulmonary hypertension. It is standard of care in the medical community to try a medication like this during the cath procedure.
 The INOvent delivers nitric oxide through a face mask.
 A patient is getting set up to breathe nitric oxide.
Side Effects
Methemoglobinemia: Oxygen is brought into the body through the lungs. It attaches itself to a protein called hemoglobin that rides along on the red blood cell. The red blood cells travel throughout the body and the hemoglobin drops off the oxygen to all the tissues and cells of the body. All body cells need oxygen to function properly. This delivery of oxygen is a continual process. Nitric oxide can change your hemoglobin to a form called methemoglobinemia. This form can not carry oxygen. If this methemoglobinemia level gets higher than normal, you may feel short of breath. The chance of this happening is very low (1 in 1000). There is a blood draw (test) that is done to check this level. We will be monitoring this level frequently throughout the study.
Bleeding: Nitric oxide can also decrease the clotting of your blood. It reduces the ability of platelets to get activated. Platelets are the cells that go to the site of injury. They clump together and plug holes in the damaged area. This risk is very low. There has been no observed increased bleeding risk in hospitalized patients breathing nitric oxide, even during surgical procedures.
NIH Pediatric Clinic
The NIH Pediatric Clinic is a multi-institute clinic with numerous specialties. It was designed to specifically to meet the needs and interests of pediatric patients. Any pediatric patients requiring outpatient assessments will be seen in this clinic.
 View of the pediatric playroom
What happens during a typical visit to the clinic?
On their first visit to the clinic, patients are examined by medical staff, which includes pediatric hematologists, nurse practitioners, research nurses/respiratory therapist. Some people will need only one visit to the clinic. Others will need follow up visits according to the research study. For instance, they might need echocardiogram or x rays. Those people will be referred to the appropriate departments at the NIH, where they will receive services. The NIH medical staff will keep your doctor at home informed about the diagnosis and treatment provided at the NIH.
 A friendly staff member welcomes you to the pediatric playroom.
Patients will have the opportunity to participate in studies to help understand pediatric hematological disorders. Natural history studies, for example, are designed to study how diseases develop and progress. In natural history studies, patients receive standard medical care. No experimental medicines or treatments are given. Other studies test a new treatment. Participation in all studies is voluntary and patients can withdraw at any time. Some of the diseases currently being studied are sickle cell disease and pulmonary hypertension.
What is available at the clinic?
Medical Evaluation and Care: Children who participate in clinical studies at the clinic will receive medical evaluation and care, including diagnostic procedures such as laboratory tests and x rays, and access to the latest investigational treatments.
Health Information: Patients and their family members can obtain health information that describes the signs and symptoms of sickle cell disease and pulmonary hypertension.
Where is the clinic located?
The NIH Pediatric Clinic is located at:
The National Institutes of Health
Mark O. Hatfield Clinical Research Center
9000 Rockville Pike
10 Center Drive
CRC, 1SE
Bethesda, MD 20892
To find out more about VMB clinical studies enrolling children, call 301-435-2345.
To find out if your child is eligible for a clinical study, call the NIH Patient Recruitment Office at 1-800-411-1222 (TTY 1-866-411-1010)
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