Venous Thromboembolism among Critically Ill Children: A Narrative Review

Anthony A. Sochet; Amy Kiskaddon; Marisol Betensky; Neil Goldenberg

doi:10.1055/s-0041-1722847

Seminars in Thrombosis and Hemostasis, Inhaltsverzeichnis

Semin Thromb Hemost 2021; 47(06): 631-642
DOI: 10.1055/s-0041-1722847

Review Article

Venous Thromboembolism among Critically Ill Children: A Narrative Review

Anthony A. Sochet

¹Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

²Division of Pediatric Critical Care Medicine, Department of Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

³Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

,

Amy Kiskaddon

³Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

⁴Department of Pharmacy, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

,

Marisol Betensky

³Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

⁵Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland

⁶Thrombosis Program, Johns Hopkins All Children's Cancer and Blood Disorder Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

,

Neil Goldenberg

³Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

⁵Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland

⁶Thrombosis Program, Johns Hopkins All Children's Cancer and Blood Disorder Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida

⁷Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

› Institutsangaben

Abstract

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality among hospitalized patients, including children. In recent years, it has become clear that hospitalization and critical illness bestow an increased VTE risk in pediatrics and relate to mortality and life-limiting comorbidities. For critically ill children, reported rates of VTE vary by study sampling techniques, presence of inherited or acquired thrombophilia, acute and chronic immobility, underlying illness prompting hospitalization, and clinical factors related to illness severity such as central venous catheterization, length of stay, mechanical ventilation, and patient age. Accordingly, critically ill children with new signs of venous congestion, acute inflammation, or unexplained acute organ dysfunction should be routinely evaluated for VTE. This narrative review summarizes recent and historical literature regarding risk factors, prevention, presentation, treatment, and outcomes of VTE in critically ill children. In addition, we identify knowledge gaps and priorities for future collaborative research on this vital condition. Special attention is given to the clinical trial opportunities, challenges, and ongoing efforts in thromboprophylaxis in critically ill children, including those hospitalized for disease related to novel coronavirus (COVID-19) and multisystem inflammatory disease in children.

Keywords

hospital-acquired VTE - pediatrics - critical care medicine - pediatric intensive care unit - thromboprophylaxis

Volltext

Referenzen

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