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Venous thromboembolism prophylaxis after pediatric trauma. Pediatr Surg Int 2021 Jun;37(6):679-694

Date

01/20/2021

Pubmed ID

33462655

DOI

10.1007/s00383-020-04855-1

Scopus ID

2-s2.0-85099339078

Abstract

In recent years, there has been an increased focus on developing and validating venous thromboprophylaxis guidelines in the pediatric trauma population. We review the current literature regarding the incidence of and risk factors for venous thromboembolism (VTE) and the use of prophylaxis in the pediatric trauma population. Risk factors such as age, injury severity, central venous catheters, mental status, injury type, surgery, and comorbidities can lead to a higher incidence of VTE. Risk stratification tools have been developed to determine whether mechanical and/or pharmacologic prophylaxis should be implemented depending on the degree of VTE risk. When VTE risk is high, pharmacologic prophylaxis, such as with low molecular weight heparin, is often initiated. However, the timing and duration of VTE prophylaxis is dependent on patient factors including ambulatory status and contraindications such as bleeding. In addition, the utility of screening ultrasound for VTE surveillance has been evaluated and though they are not widely recommended, no formal guidelines exist. While more research has been done in recent years to assess the most appropriate type, timing, and duration of VTE prophylaxis, further studies are warranted to create optimal guidelines for decreasing the risk of VTE after pediatric trauma.

Author List

Georgeades C, Van Arendonk K, Gourlay D

Authors

David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Kyle Van Arendonk MD, PhD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Anticoagulants
Child
Global Health
Humans
Incidence
Risk Factors
Venous Thromboembolism
Wounds and Injuries