Liver biopsies in patients with lysosomal storage disease: experience with effective sedation

Indian J Pediatr. 1997 Nov-Dec;64(6):887-91. doi: 10.1007/BF02725518.

Abstract

We prospectively applied a protocol used to sedate children who required a liver biopsy. Sixty liver biopsies were performed on thirty pediatric patients to assess the effects of treatment. Sixteen patients had Type 1 Gaucher's disease of which seven had a platelet count between 50-100,000/mm3. All seven had bleeding time performed and when indicated, intravenous DDAVP (1-deamino-8-D-arginine vasopressin) was used to improve hemostasis. Fourteen patients had Niemann-Pick disease type C of which eight were significantly demented and uncooperative. Before liver biopsy, all patients were sedated with the following regimen: oral chlorpromazine (1 mg/kg) followed one hour later by intravenous meperidine (1 mg/kg) and pentobarbital (maximum dosage 6 mg/kg) administered by slow intravenous injection. Liver biopsies were obtained safely on all patients. Only 1 patient (2%) developed a potentially serious complication: an obstructed airway which was readily corrected by simple repositioning. Transient less serious complications occurred in another 7 patients (12%). There was no long term sequalae of the biopsy procedures. Our study indicates that with appropriate patient selection, this sedation protocol may be useful in pediatric patients requiring a liver biopsy.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Biopsy, Needle
  • Child
  • Child, Preschool
  • Conscious Sedation / methods*
  • Female
  • Humans
  • Liver / pathology*
  • Lysosomal Storage Diseases / diagnosis*
  • Male
  • Prospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome