TY - JOUR
T1 - Screening and Prophylaxis for Venous Thromboembolism in Pediatric Surgery
T2 - A Systematic Review
AU - Kelley-Quon, Lorraine I.
AU - Acker, Shannon N.
AU - St Peter, Shawn
AU - Goldin, Adam
AU - Yousef, Yasmine
AU - Ricca, Robert L.
AU - Mansfield, Sara A.
AU - Sulkowski, Jason P.
AU - Huerta, Carlos T.
AU - Lucas, Donald J.
AU - Rialon, Kristy L.
AU - Christison-Lagay, Emily
AU - Ham, P. Benson
AU - Rentea, Rebecca M.
AU - Beres, Alana L.
AU - Kulaylat, Afif N.
AU - Chang, Henry L.
AU - Polites, Stephanie F.
AU - Diesen, Diana L.
AU - Gonzalez, Katherine W.
AU - Wakeman, Derek
AU - Baird, Robert
N1 - Publisher Copyright:
© 2024
PY - 2024/10
Y1 - 2024/10
N2 - Objective: The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee conducted a systematic review to describe the epidemiology of venous thromboembolism (VTE) in pediatric surgical and trauma patients and develop recommendations for screening and prophylaxis. Methods: The Medline (Ovid), Embase, Cochrane, and Web of Science databases were queried from January 2000 through December 2021. Search terms addressed the following topics: incidence, ultrasound screening, and mechanical and pharmacologic prophylaxis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available literature. Results: One hundred twenty-four studies were included. The incidence of VTE in pediatric surgical populations is 0.29% (Range = 0.1%–0.48%) and directly correlates with surgery type, transfusion, prolonged anesthesia, malignancy, congenital heart disease, inflammatory bowel disease, infection, and female sex. The incidence of VTE in pediatric trauma populations is 0.25% (Range = 0.1%–0.8%) and directly correlates with injury severity, major surgery, central line placement, body mass index, spinal cord injury, and length-of-stay. Routine ultrasound screening for VTE is not recommended. Consider sequential compression devices in at-risk nonmobile, pediatric surgical patients when an appropriate sized device is available. Consider mechanical prophylaxis alone or with pharmacologic prophylaxis in adolescents >15 y and post-pubertal children <15 y with injury severity scores >25. When utilizing pharmacologic prophylaxis, low molecular weight heparin is superior to unfractionated heparin. Conclusions: While VTE remains an infrequent complication in children, consideration of mechanical and pharmacologic prophylaxis is appropriate in certain populations. Type of Study: Systematic Review of level 2–4 studies. Level of Evidence: Level 3-4.
AB - Objective: The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee conducted a systematic review to describe the epidemiology of venous thromboembolism (VTE) in pediatric surgical and trauma patients and develop recommendations for screening and prophylaxis. Methods: The Medline (Ovid), Embase, Cochrane, and Web of Science databases were queried from January 2000 through December 2021. Search terms addressed the following topics: incidence, ultrasound screening, and mechanical and pharmacologic prophylaxis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available literature. Results: One hundred twenty-four studies were included. The incidence of VTE in pediatric surgical populations is 0.29% (Range = 0.1%–0.48%) and directly correlates with surgery type, transfusion, prolonged anesthesia, malignancy, congenital heart disease, inflammatory bowel disease, infection, and female sex. The incidence of VTE in pediatric trauma populations is 0.25% (Range = 0.1%–0.8%) and directly correlates with injury severity, major surgery, central line placement, body mass index, spinal cord injury, and length-of-stay. Routine ultrasound screening for VTE is not recommended. Consider sequential compression devices in at-risk nonmobile, pediatric surgical patients when an appropriate sized device is available. Consider mechanical prophylaxis alone or with pharmacologic prophylaxis in adolescents >15 y and post-pubertal children <15 y with injury severity scores >25. When utilizing pharmacologic prophylaxis, low molecular weight heparin is superior to unfractionated heparin. Conclusions: While VTE remains an infrequent complication in children, consideration of mechanical and pharmacologic prophylaxis is appropriate in certain populations. Type of Study: Systematic Review of level 2–4 studies. Level of Evidence: Level 3-4.
KW - Deep vein thrombosis
KW - Pediatric
KW - Surgery
KW - Venous thromboembolism
UR - https://www.scopus.com/pages/publications/85197190968
U2 - 10.1016/j.jpedsurg.2024.05.015
DO - 10.1016/j.jpedsurg.2024.05.015
M3 - Review article
C2 - 38964986
AN - SCOPUS:85197190968
SN - 0022-3468
VL - 59
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 10
M1 - 161585
ER -