Abstract
Hamilton, Ont. Children with suspected venous thromboembolic disease are not uncommonly seen in pediatric referral centres. The only objective test widely accepted In pediatrics for the assessment of deep vein thrombosis (DVT) is venography. Impedance plethysmography (IPG) has been proven safe in adults. We have performed a feasibility study of clinical use of IPC in children with suspected DVT. We studied 14 consecutive patients who presented with pain, swelling or erythema of a lower extremity. Their ages ranged from 7-18 yrs. with a median of 16 yrs and a mean of 15.5 yrs. We performed IPG on both legs using the technique described In adults. Only patients with positive(+) IPG underwent venography. All three patients with +IPG had venogram-confirmed DVT. Deficiencies of proteins C&S, AT III and plasminogen were not found. The patients with negative(-) IPG were followed with repeat IPG at days 0, 1, 3, 5, 7 and 10. The IPG remained (-) in these patients.None of the 11 patients with (-)IPG subsequently developed clinical evidence of DVT. Large trials in symptomatic adults have demonstrated that IPG may replace venography. Although no technical problems were encountered with IPG In our patients, there are 2 potential problems in using IPG in children:(1)patlent cooperation in small children;(2)the use of adult-sized cuffs in small chlldren. It should be possible to overcome the latter by modifying cuff size. We feel a larger experience with the use of IPG in children with symptoms or signs of DVT is required. We conclude that IPG which has been validated in adults, has utility in the diagnosis of venous thromboembolic disease in children.
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Turner, C., Andrew, M., Hull, R. et al. UTILITY OF IMPEDANCE PLETHYSMOGRAPHY IN CHILDREN WITH CLINICALLY SUSPECTED VENOUS THROMBOEMBOLIC DISEASE. Pediatr Res 21 (Suppl 4), 307 (1987). https://doi.org/10.1203/00006450-198704010-00838
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DOI: https://doi.org/10.1203/00006450-198704010-00838