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Pediatric thromboembolism

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https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#1
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29749594/-non-aneurysmal-subarachnoid-haemorrhage-secondary-to-panarteritis-nodosa-at-paediatric-age-a-case-report
#2
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29749291/antithrombotic-therapy-in-pediatric-ventricular-assist-devices-multicenter-survey-of-the-european-excor-pediatric-investigator-group
#3
Oliver Miera, Katharina L Schmitt, Hakan Akintuerk, Angele Boet, Robert Cesnjevar, Teresa Chila, Thilo Fleck, Ranny Goldwasser, Luis G Guereta, Beatrice Heineking, Juergen Hoerer, Alexander Horke, Tain Y Hsia, Michael Huebler, Andrzej Kansy, Ann Karimova, Bohdan Maruszewski, Constancio Medrano, Szymon Pawlak, Zdenka Reinhardt, Birgitta Romlin, Eugen Sandica, Florian Schmidt, René Schramm, Martin Schweiger, Joanna Śliwka, Brigitte Stiller, Josef Thul, Antonio Amodeo
OBJECTIVES: Mechanical circulatory support for pediatric heart failure patients with the Berlin Heart EXCOR ventricular assist system is the only approved and established bridging strategy for recovery or heart transplantation. In recent years, the burden of thromboembolic events has led to modifications of the recommended antithrombotic therapy. Therefore, we aimed to assess modifications of antithrombotic practice among the European EXCOR Pediatric Investigator Group members. METHODS: We sent a questionnaire assessing seven aspects of antithrombotic therapy to 18 European hospitals using the EXCOR device for children...
May 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#4
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29703491/thrombosis-in-pediatric-patients-with-leukemia
#5
Sarina Levy-Mendelovich, Assaf Arie Barg, Gili Kenet
Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children. It is reportedly the most common malignancy associated with thromboembolism in the pediatric age group. Over the last 2 decades, venous thromboembolism (VTE) has been increasingly diagnosed among pediatric ALL patients with an estimated incidence ranging from about 5% (for symptomatic cases) to about 30-70% (following sequential imaging studies in asymptomatic children). The etiology is multifactorial and may stem from alterations of the hemostatic system following various chemotherapy protocols (including use of l-Asparaginase), the presence of central venous lines (CVL), as well as comorbidities, e...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29700892/prevention-of-perioperative-venous-thromboembolism-in-pediatric-patients-guidelines-from-the-association-of-paediatric-anaesthetists-of-great-britain-and-ireland-apagbi
#6
Judith Morgan, Matthew Checketts, Amaia Arana, Elizabeth Chalmers, Jamie Maclean, Mark Powis, Neil Morton
The Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Guidelines Working Group on Thromboprophylaxis in Children has reviewed the literature and where possible provided advice on the care of children in the perioperative period. Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29685556/pathophysiology-of-thrombosis-and-anticoagulation-post-fontan-surgery
#7
Chantal Attard, Joanna Huang, Paul Monagle, Vera Ignjatovic
The Fontan procedure has transformed the lives of children born with single-ventricle physiology, previously deemed inoperable. Worldwide, there are an increasing number of children with Fontan circulation, with the potential for survival into adulthood. Due to the abnormal circulation, Fontan patients have an increased risk of thromboembolic (TE) events, with up to 25% of events leading to death. Despite the importance of preventing TE events in this patient population, there is currently no clinical consensus on the optimal monitoring, thromboprophylaxis therapies, and treatment of these events...
April 14, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29661787/thromboembolism-in-acute-lymphoblastic-leukemia-results-of-nopho-all2008-protocol-treatment-in-patients-1-45-years
#8
Cecilie Utke Rank, Nina Toft, Ruta Tuckuviene, Kathrine Grell, Ove Juul Nielsen, Thomas Leth Frandsen, Hanne Vibeke Hansen Marquart, Birgitte Klug Albertsen, Ulf Tedgård, Helene Hallböök, Ellen Ruud, Kirsten Brunsvig Jarvis, Petter Quist-Paulsen, Pasi Huttunen, Ulla Wartiovaara-Kautto, Ólafur Gísli Jónsson, Sonata Saulyte Trakymiene, Laimonas Griškevičius, Kadri Saks, Mari Punab, Kjeld Schmiegelow
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during treatment of 1772 consecutive Nordic/Baltic ALL patients 1-45years treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol (7/2008-4/2017). The 2.5-year cumulative incidence of thromboembolism (N=137) was 7.9% (95% confidence interval (CI) 6.6-9.1); higher in patients ≥10years ( P <.0001). Adjusted hazard ratios (HRa) were associated with greater age (10...
April 16, 2018: Blood
https://www.readbyqxmd.com/read/29628848/wilm-s-tumor-with-intracardiac-extension-causing-dynamic-tricuspid-valve-obstruction-an-anesthetic-challenge
#9
Kamal Kajal, Ganesh Kumar Munirathinam, Banashree Mandal, Komal Gandhi, Harkant Singh, Ravi Kanojia
Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29610692/successful-complete-response-of-tumor-thrombus-after-combined-with-chemotherapy-and-irradiation-for-ewing-sarcoma
#10
Yusuke Minami, Seiichi Matsumoto, Keisuke Ae, Taisuke Tanizawa, Keiko Hayakawa, Yuki Funauchi, Sakae Okumura, Yutaka Takazawa
Pelvic Ewing sarcoma is associated with a worse prognosis. Thromboembolic events are relatively common in pediatric patients with cancers including sarcomas. We have presented a case of Ewing sarcoma arising from the left iliac bone with tumor thrombus of inferior vena cava (IVC) which was obtained complete response by both chemotherapy and irradiation. Magnetic resonance imaging (MRI) scan demonstrated that the tumor arising from the left iliac bone extended into the left side of sacral bone, suggesting the difficulty of surgical resection...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29605581/hematological-complications-in-children-subjected-to-extracorporeal-membrane-oxygenation
#11
M J Santiago, C Gómez, I Magaña, V Muñoz, P Saiz, A Sánchez, J López-Herce
OBJECTIVES: To analyze the hematological complications and need for transfusions in children receiving extracorporeal life support (ECLS). DESIGN: A retrospective study was carried out. SETTING: A pediatric intensive care unit. PATIENTS: Children under 18 years of age treated with ECLS between September 2006 and November 2015. INTERVENTIONS: None. VARIABLES OF INTEREST: Patient and ECLS characteristics, anticoagulation, hematological and coagulation parameters, transfusions and clinical course...
March 29, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29592538/enoxaparin-dosing-at-extremes-of-weight-literature-review-and-dosing-recommendations
#12
Jamie Sebaaly, Kelly Covert
OBJECTIVE: To review the literature on both thromboprophylaxis and treatment of venous thromboembolism (VTE) with enoxaparin in low- and high-body-weight patients and to make dosing and monitoring recommendations in these patient populations. DATA SOURCES: A search using PubMed was conducted (1995 to January 2018) using the following key words: enoxaparin, body weight, AND thromboprophylaxis, or AND treatment. Additional references were identified from a review of citations...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29577520/the-impact-of-thromboelastography-on-resuscitation-in-pediatric-liver-transplantation
#13
Joseph Sujka, Katherine W Gonzalez, Kayla L Curiel, James Daniel, Ryan T Fischer, Walter S Andrews, Brian M Wicklund, Richard J Hendrickson
Although TEG directs effective resuscitation in adult surgical patients, pediatric data are lacking. We performed a retrospective comparative review of the effect of TEG on blood product utilization and outcomes following pediatric liver transplantation in 38 patients between 2008 and 2014. Diagnoses, laboratory values, fluid and blood product use, and outcomes were examined. Nineteen patients underwent liver transplantation prior to the implementation of TEG, and 19 had perioperative TEG. The most common indications for transplant were BA (n = 14), HB (n = 7), and metabolic disorders (n = 7)...
March 26, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29567586/obesity-and-risk-for-venous-thromboembolism-from-contemporary-therapy-for-pediatric-acute-lymphoblastic-leukemia
#14
Saskia Prasca, Roxana Carmona, Lingyun Ji, Richard H Ko, Deepa Bhojwani, Yasmin A Rawlins, Steven D Mittelman, Guy Young, Etan Orgel
INTRODUCTION: Acute lymphoblastic leukemia (ALL) therapy confers risk for venous thromboembolism (VTE) and associated acute and long-term morbidity. Obesity increases VTE risk in the general population but its impact on ALL therapy-associated VTE is unknown. METHODS: In a retrospective cohort of children treated for ALL between 2008 and 2016 (n = 294), we analyzed obesity at diagnosis (body mass index [BMI] ≥95%) and subsequent development of VTE. A subset participated in two concurrent prospective ALL trials studying body composition via dual-energy X-ray absorptiometry (DXA) (n = 35) and hypercoagulability via thromboelastography (TEG) (n = 46)...
March 2, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29530427/the-association-between-otogenic-lateral-sinus-thrombosis-and-thrombophilia-a-long-term-follow-up
#15
Shay Schneider, Joseph Kapelushnik, Mordechai Kraus, Sabri El Saied, Itai Levi, Daniel Michael Kaplan
PURPOSE: Otogenic lateral sinus thrombosis (OLST) is an intracranial, potentially life-threatening complication of acute and chronic otitis media. Since congenital thrombophilic disorders are risk factors for cerebral venous thrombosis, OLST may be related to thrombophilia. The aim of our study was twofold: to evaluate whether patients who suffered from OLST in childhood also have thrombophilia, and whether these patients experienced thromboembolic episodes in future years. STUDY DESIGN: Retrospective case series...
May 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29501323/antithrombotic-therapies-in-children-on-durable-ventricular-assist-devices-a-literature-review
#16
Joanna Y Huang, Paul Monagle, M Patricia Massicotte, Christina J VanderPluym
INTRODUCTION: Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients...
February 28, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29500504/development-and-implementation-of-a-standardized-heparin-protocol-for-left-sided-pediatric-electrophysiology-procedures
#17
Emily F Moore, Jennifer Pak, Christa Jefferis-Kirk, Arlene Armatage, Richard A Kronmal, Jack C Salerno, Matthew D Files
Heparin is used to decrease the risk of thromboembolic complications during electrophysiology studies (EPS); however, there is wide practice variation and minimal evidence to guide heparin dosing, particularly in pediatric patients. This study retrospectively analyzed heparin dosing and response, measured via activated clotting time (ACT), in patients undergoing EPS and used these data (pre-protocol cohort, n = 40), as well as guidance from available literature to implement a standardized heparin protocol (phase 1, n = 43)...
March 2, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29472108/pediatric-issues-in-thrombosis-and-hemostasis-the-how-and-why-of-venous-thromboembolism-risk-stratification-in-hospitalized-children
#18
Brian R Branchford, Marisol Betensky, Neil A Goldenberg
Multiple observational studies have identified risk factors for venous thromboembolism (VTE) in hospitalized children, but very few interventional studies have assessed the safety and efficacy of thromboprophylaxis in this population. In recent years, however, evidence in pediatric VTE risk stratification has grown considerably. This has led to the conception of a pediatric subpopulation-specific risk-based paradigm for mechanical and pharmacological thromboprophylaxis in hospitalized children. More research is required to validate and further refine pediatric subpopulation-specific risk models and to subsequently investigate risk-stratified thromboprophylaxis strategies for hospitalized children...
February 17, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29431623/prevalence-and-risk-factors-for-venous-thromboembolism-in-children-with-sickle-cell-disease-an-administrative-database-study
#19
Riten Kumar, Joseph Stanek, Susan Creary, Amy Dunn, Sarah H O'Brien
A hypercoagulable state resulting in increased venous thromboembolism (VTE) has been described in adults with sickle cell disease (SCD), but similar data for children are lacking. The objective of this retrospective cohort study was to describe the rate of VTE and risk factors associated with VTE in children with SCD across tertiary-care children's hospitals in the United States between the years 2009 and 2015. We used the Pediatric Health Information System database to investigate all pediatric patients with SCD admitted to 1 of 48 participating institutions between 1 January 2009 and 30 September 2015...
February 13, 2018: Blood Advances
https://www.readbyqxmd.com/read/29407627/transition-of-care-for-patients-with-venous-thromboembolism-rationale-design-and-implementation-of-a-quality-intervention-project-conducted-at-american-thrombosis-and-hemostasis-network-athn-affiliated-sites
#20
Julie Jaffray, Madhvi Rajpurkar, Anjali Sharathkumar, Kavita Patel, James Munn, Dunlei Cheng, Ellen McCarthy, Maria DeSancho
INTRODUCTION: Medication errors frequently occur during transition from the inpatient to outpatient setting. Anticoagulants are associated with serious medical errors, including major bleeding. Standardized transition of care (TOC) techniques in patients with venous thromboembolism (VTE) have not been developed. METHODS: This ongoing project conducted by the American Thrombosis and Hemostasis Network (ATHN) aims to improve TOC for newly diagnosed VTE patients on anticoagulation from the inpatient to outpatient setting, and identify characteristics of patients on direct oral anticoagulants (DOACs) and their TOC...
March 2018: Thrombosis Research
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