Deep vein thrombosis in patients with neuromuscular disease who undergo tracheotomy with positive pressure ventilation.

Background: Deep vein thrombosis and its progression to pulmonary thromboembolism is a major source of mortality in patients with neuromuscular disease. Furthermore, ventilator use poses a high risk of DVT to patients. Methods: Hospitalized patients with neuromuscular disease who underwent tracheotomy with positive pressure ventilation (TPPV) had DVT evaluated in the lower extremities by ongoing whole leg venous ultrasonography. Patients who were diagnosed with DVT underwent a second ultrasonography 1 month later. The attending physicians decided on therapeutic measures. All patients were followed during the study period. Results: Eight of 33 patients had DVT. The site of DVT formation was the iliac veins in three cases, femoral veins in two cases, and calf veins in three cases. All of the patients with DVT were asymptomatic. There was no difference in the clinical future between patients with DVT and those without DVT. Progression of DVT was not observed in the second ultrasonographic examination 1 month later. All patients with DVT had an excellent prognosis after a follow‐up period of 9 months. Conclusion: The prevalence of DVT in patients with neuromuscular disease who undergo TPPV might be high. Further large studies on this issue are required because the clinical significance of this DVT is uncertain. [ABSTRACT FROM AUTHOR]