Subject(s)
Adenocarcinoma/diagnostic imaging , Asthma/diagnosis , Lung Neoplasms/diagnostic imaging , Respiratory Sounds/etiology , Adenocarcinoma/complications , Adenocarcinoma/secondary , Asthma/diagnostic imaging , Bronchial Spasm/etiology , Bronchoscopy , Female , Humans , Kidney Neoplasms , Lung Neoplasms/complications , Lung Neoplasms/secondary , Middle Aged , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
We report our experience with five children with pulmonary embolism and infarction. Two with congenital heart disease, one with rheumatic cardiopathy and two with a previously healthy cardiopulmonary system. The risk factors, clinical behavior and ECG were similar to those in adults. In chest roentgenogram we found pulmonary infarction with cavitations in three patients because of a delayed diagnosis. All patients had hypoxemia and hypocapnia, and diagnosis was made on the basis of segmentary or larger defects in perfusion gammagraphy. In just one case we obtained V/Q gammagraphy and pulmonary angiography. In one case we confirmed the clinical diagnosis by autopsy. We conclude that it is very important to keep this diagnosis in mind in all children with respiratory failure.
Subject(s)
Pulmonary Embolism/diagnosis , Adolescent , Child , Child, Preschool , Female , Heparin/administration & dosage , Humans , Male , Pulmonary Embolism/drug therapy , RecurrenceABSTRACT
Information is lacking about the prevalence of, and the best method of preventing deep venous thrombosis (DVT) of the lower extremities in patients forty years or older with pulmonary disease that keeps them in bed for three consecutive days or more and who are thus at high risk of developing DVT or pulmonary embolism (PE). In this study, 192 high-risk patients, aged forty to ninety-two, received 125I fibrinogen and had daily radioactive scans, venous Doppler, and strain gauge plethysmography. Four preventive methods were used until patients became ambulatory: graded compression stockings (GCS) in 39, elastic bandages (EB) in 33, subcutaneous administration of 5,000 USP units of heparin (HEP) bid in 39, and oral administration of 0.5 g of acetylsalicyclic acid (ASA) bid in 35. Results were compared with those in 46 patients in a control group (CG). Twelve patients in CG, none in GCS, 4 in EB, 1 in HEP, and 2 in ASA developed DVT proved by contrast venography. There was a statistically significant difference between GCS and CG (P less than 0.0003), HEP and CG (P less than 0.0022), and ASA and CG (P less than 0.0148) but not between EB and CG (P greater than 0.10); no significant differences were found between any pair of prophylaxis groups. The significant differences could not be attributed to differences in age, sex, or length of stay in bed. PE occurred in 3 patients in CG and 1 in EB. Hemorrhagic complications occurred in 7 patients in HEP and 4 in ASA, requiring exclusion of 2 patients and 1 patient, respectively, from the study.(ABSTRACT TRUNCATED AT 250 WORDS)
