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pediatric venous thromboembolism

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...
March 7, 2018: American Journal of Otolaryngology
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
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
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...
February 1, 2018: Thrombosis Research
Kimberly K Abood, Megan Rose Paul, Dennis John Kuo
Venous thromboembolism is becoming increasingly recognized as a significant cause of morbidity and mortality in the hospitalized pediatric population. However, young healthy athletes can present with unique risk factors for deep vein thrombosis (DVT) that can be overlooked. Here we report a case of an adolescent male with no inherited risk factors or prior history of DVTs who developed a right femoral vein DVT in the context of playing catcher in baseball after recovering from a bout of streptococcal pharyngitis...
February 2, 2018: Journal of Pediatric Hematology/oncology
Sarah B Cairo, Timothy B Lautz, Beverly A Schaefer, Guan Yu, Hibbut-Ur-Rauf Naseem, David H Rothstein
BACKGROUND: Venous thromboembolism (VTE) in pediatric surgical patients is a rare event. The risk factors for VTE in pediatric general surgery patients undergoing abdominopelvic procedures are unknown. STUDY DESIGN: The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015) was queried for patients with VTE after abdominopelvic general surgery procedures. Patient and operative variables were assessed to identify risk factors associated with VTE and develop a pediatric risk score...
December 27, 2017: Journal of Pediatric Surgery
A Theron, C Biron-Andreani, S Haouy, L Saumet, M Saguintah, E Jeziorski, N Sirvent
The survival rate of children with cancer is now close to 80 %, as a result of continuous improvement in diagnostic and treatment procedures. Prevention and treatment of treatment-associated complications is now a major challenge. Thromboembolic venous disease, due to multifactorial pathogenesis, is a frequent complication (up to 40 % asymptomatic thrombosis in children with cancer), responsible for significant morbidity. Predominantly in children with acute lymphoblastic leukemia, lymphoma, or sarcoma, thromboembolic disease justifies primary prophylaxis in certain populations at risk, whether genetic or environmental...
January 8, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ryan W Morgan, Hannah R Stinson, Heather Wolfe, Robert B Lindell, Alexis A Topjian, Vinay M Nadkarni, Robert M Sutton, Robert A Berg, Todd J Kilbaugh
OBJECTIVES: Pulmonary embolism is a rarely reported and potentially treatable cause of cardiac arrest in children and adolescents. The objective of this case series is to describe the course of five adolescent patients with in-hospital cardiac arrest secondary to pulmonary embolism. DESIGN: Case series. SETTING: Single, large academic children's hospital. PATIENTS: All patients under the age of 18 years (n = 5) who experienced an in-hospital cardiac arrest due to apparent pulmonary embolism from August 1, 2013, to July 31, 2017...
March 2018: Critical Care Medicine
Rachael F Grace, Daniel J DeAngelo, Kristen E Stevenson, Donna Neuberg, Stephen E Sallan, Yasser R Abou Mourad, Julie Bergeron, Matthew D Seftel, Caroline Kokulis, Jean M Connors
Treatment for acute lymphoblastic leukemia (ALL) in adults confers a high risk of venous thromboembolic (VTE) complications. We describe the implementation and results of prophylactic anticoagulation guidelines in adults (18-50 years) treated on a Dana-Farber Cancer Institute ALL pediatric inspired consortium protocol from 2007 to 2013. A high rate of asparaginase related toxicity events, including thrombosis, resulted in a protocol amendment adding guidelines for prophylactic anticoagulation and a modified asparaginase dose and schedule...
December 19, 2017: Journal of Thrombosis and Thrombolysis
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
January 2018: Thrombosis Research
Julie Jaffray, Arash Mahajerin, Guy Young, Neil Goldenberg, Lingyun Ji, Richard Sposto, Amy Stillings, Emily Krava, Brian Branchford
BACKGROUND: Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. OBJECTIVES: This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model...
January 2018: Thrombosis Research
Cristina Tarango, Sam Schulman, Marisol Betensky, Neil A Goldenberg
Compared with the incidence of venous thromboembolism in the adult population, pediatric VTE is rare. Yet, recent data suggest that the incidence of VTE in children is increasing, and little is known about the optimal duration of anticoagulation in pediatrics. Areas covered: This review summarizes current evidence-based adult recommendations and associated clinical trials from which current guidelines on the duration of anticoagulation in children have been extrapolated. It also discusses pediatric expert consensus-based guidelines and current pediatric clinical trials on duration of therapy in pediatric VTE...
January 2018: Expert Review of Hematology
B P Tullius, U Athale, C H van Ommen, A K C Chan, J S Palumbo, J M S Balagtas
No abstract text is available yet for this article.
January 2018: Journal of Thrombosis and Haemostasis: JTH
Guy Young
Venous thromboembolism is occurring with increasing frequency in children resulting in the more widespread use of anticoagulation in pediatrics. Antithrombotic drugs in children can be divided into the standard and alternative agents. This review discusses standard and alternative anticoagulants. Because standard anticoagulants have significant limitations, including variable pharmacokinetics, issues with therapeutic drug monitoring, frequency of administration, efficacy, and adverse effects, it is expected that the use of alternative anticoagulants will increase over time...
December 2017: Pediatric Clinics of North America
Cornelia H van Ommen
Despite the increasing incidence of venous thromboembolic disease in pediatric patients, it remains a rare complication in childhood. Particularly neonates and adolescents are at risk for development of venous thrombosis. Spontaneous thrombotic events are sporadic, the majority of children have multiple co-existing risk factors, including central venous catheter, asphyxia, congenital heart disease, infection, malignancy, surgery and hypovolemia. Most thrombi are diagnosed by ultrasonography. Recommendations for management of pediatric thrombosis are typically extrapolated from adult studies, despite many differences between adults and children, including developmental hemostasis...
November 21, 2017: Minerva Pediatrica
Hemalatha G Rangarajan, Joseph R Stanek, Rolla Abu-Arja, Rajinder P S Bajwa, Jeffery J Auletta, Dean A Lee, Sarah H O'Brien, Riten Kumar
Hematopoietic cell transplant (HCT) is associated with a proinflammatory, procoagulant environment that places recipients at increased risk of venous thromboembolism (VTE). Although the incidence of VTE in adult HCT recipients has been extensively studied, similar data for children are lacking. We conducted a multicenter retrospective study to analyze the prevalence of VTE and associated risk factors in a large cohort of patients who underwent HCT at tertiary care US children's hospitals. The Pediatric Health Information System database, a large administrative database that contains clinical and resource utilization data from 49 freestanding children's hospitals in the United States, was used to extract data...
February 2018: Biology of Blood and Marrow Transplantation
Ayesha Zia, Joy Russell, Ravi Sarode, Surendranath R Veeram, Shellie Josephs, Kendra Malone, Song Zhang, Janna Journeycake
BACKGROUND: Sequelae of venous thromboembolism (VTE) in children include recurrence, development of post thrombotic syndrome (PTS) when venous return from a limb is affected and chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary embolism. Identification of laboratory-based risk factors may be useful for individualized risk assessment for VTE sequelae. Coagulation activation and inflammation may contribute to their pathophysiology. We performed a systematic review to investigate the association between biomarkers of coagulation activation, inflammation and fibrinolysis and adverse VTE outcomes in children and young adults...
December 2017: Thrombosis Research
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
B R Branchford, A Mahajerin, L Raffini, E Chalmers, C H van Ommen, A K C Chan, N A Goldenberg
No abstract text is available yet for this article.
November 2017: Journal of Thrombosis and Haemostasis: JTH
Char M Witmer, Clifford M Takemoto
Pediatric hospital acquired venous thromboembolism (HA-VTE) is an increasing problem with an estimated increase from 5.3 events per 10,000 pediatric hospital admissions in the early 1990s to a current estimate of 30-58 events per 10,000 pediatric hospital admissions. Pediatric HA-VTE is associated with significant morbidity and mortality. The etiology is multifactorial but central venous catheters remain the predominant risk factor. Additional HA-VTE risk factors include both acquired (recent surgery, immobility, inflammation, and critical illness) and inherited risk factors...
2017: Frontiers in Pediatrics
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