Cargando…
Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines
Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is a potentially preventable condition in children. In adults, pharmacologic prophylaxis has been shown to significantly reduce the incidence of venous thromboembolism in distinct patient cohorts. However, pediatri...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266715/ https://www.ncbi.nlm.nih.gov/pubmed/28184368 http://dx.doi.org/10.3389/fped.2017.00009 |
_version_ | 1782500499866517504 |
---|---|
author | Faustino, E. Vincent S. Raffini, Leslie J. |
author_facet | Faustino, E. Vincent S. Raffini, Leslie J. |
author_sort | Faustino, E. Vincent S. |
collection | PubMed |
description | Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is a potentially preventable condition in children. In adults, pharmacologic prophylaxis has been shown to significantly reduce the incidence of venous thromboembolism in distinct patient cohorts. However, pediatric randomized controlled trials have failed to demonstrate the efficacy of pharmacologic prophylaxis against thrombosis associated with central venous catheters, the most important risk factor for venous thromboembolism in children. Despite the lack of supporting evidence, hospital-based initiatives are being undertaken to try to prevent venous thromboembolism in children. In this study, we sought to review the published guidelines on the prevention of venous thromboembolism in hospitalized children. We identified five guidelines, all of which were mainly targeted at adolescents and used various risk-stratification approaches. In low-risk children, ambulation was the recommended prevention strategy, while mechanical prophylaxis was recommended for children at moderate risk and pharmacologic and mechanical prophylaxis were recommended for the high-risk group. The effectiveness of these strategies has not been proven. In order to determine whether venous thromboembolism can be prevented in children, innovative clinical trial designs are needed. In the absence of these trials, guidelines can be a source of valuable information to inform our practice. |
format | Online Article Text |
id | pubmed-5266715 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-52667152017-02-09 Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines Faustino, E. Vincent S. Raffini, Leslie J. Front Pediatr Pediatrics Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is a potentially preventable condition in children. In adults, pharmacologic prophylaxis has been shown to significantly reduce the incidence of venous thromboembolism in distinct patient cohorts. However, pediatric randomized controlled trials have failed to demonstrate the efficacy of pharmacologic prophylaxis against thrombosis associated with central venous catheters, the most important risk factor for venous thromboembolism in children. Despite the lack of supporting evidence, hospital-based initiatives are being undertaken to try to prevent venous thromboembolism in children. In this study, we sought to review the published guidelines on the prevention of venous thromboembolism in hospitalized children. We identified five guidelines, all of which were mainly targeted at adolescents and used various risk-stratification approaches. In low-risk children, ambulation was the recommended prevention strategy, while mechanical prophylaxis was recommended for children at moderate risk and pharmacologic and mechanical prophylaxis were recommended for the high-risk group. The effectiveness of these strategies has not been proven. In order to determine whether venous thromboembolism can be prevented in children, innovative clinical trial designs are needed. In the absence of these trials, guidelines can be a source of valuable information to inform our practice. Frontiers Media S.A. 2017-01-26 /pmc/articles/PMC5266715/ /pubmed/28184368 http://dx.doi.org/10.3389/fped.2017.00009 Text en Copyright © 2017 Faustino and Raffini. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Faustino, E. Vincent S. Raffini, Leslie J. Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title | Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title_full | Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title_fullStr | Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title_full_unstemmed | Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title_short | Prevention of Hospital-Acquired Venous Thromboembolism in Children: A Review of Published Guidelines |
title_sort | prevention of hospital-acquired venous thromboembolism in children: a review of published guidelines |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266715/ https://www.ncbi.nlm.nih.gov/pubmed/28184368 http://dx.doi.org/10.3389/fped.2017.00009 |
work_keys_str_mv | AT faustinoevincents preventionofhospitalacquiredvenousthromboembolisminchildrenareviewofpublishedguidelines AT raffinilesliej preventionofhospitalacquiredvenousthromboembolisminchildrenareviewofpublishedguidelines |