Venous thromboembolism prophylaxis after pediatric trauma

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.

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All the authors contributed to the review article. All the authors performed a literature review and provided articles relevant to the topic. The first draft of the manuscript and tables were written by Christina Georgeades and all the authors commented on subsequent versions of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Christina Georgeades.

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Georgeades, C., Van Arendonk, K. & Gourlay, D. Venous thromboembolism prophylaxis after pediatric trauma. Pediatr Surg Int 37, 679–694 (2021). https://doi.org/10.1007/s00383-020-04855-1

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Keywords

  • Venous thromboembolism
  • Pediatric trauma
  • Pharmacologic prophylaxis
  • Risk factors
  • Central venous catheters
  • Ultrasound screening