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Published on: February 10, 2023

Venous thromboembolism in pediatrics

N Anton1, M P Massicotte

  • 1Hematology, Hospital for Sick Children, Toronto, Ontario, Canada.

Seminars in Vascular Medicine
|June 17, 2004
PubMed

Insights

Pediatric venous thromboembolism (VTE) is a growing concern, often linked to serious illnesses and central venous lines (CVLs). Low molecular weight heparin (LMWH) is a preferred treatment due to its advantages over unfractionated heparin (UFH).

Area of Science:

  • Pediatric Thrombosis
  • Vascular Medicine
  • Hematology

Background:

  • Pediatric venous thromboembolism (VTE) is an increasingly recognized cause of significant morbidity and mortality in children.
  • VTE in children is often associated with serious underlying conditions like cancer, chronic total parenteral nutrition (TPN) dependency, or congenital heart disease.
  • Infants and adolescents are particularly at risk, with central venous lines (CVLs) being the most significant risk factor.

Purpose of the Study:

  • To review the current understanding of pediatric VTE, including incidence, risk factors, diagnosis, treatment, and complications.
  • To highlight the advantages of low molecular weight heparin (LMWH) over unfractionated heparin (UFH) in pediatric VTE management.
  • To discuss the acute and long-term morbidities associated with VTE in children.

Main Methods:

  • Literature review of studies on pediatric venous thromboembolism.
  • Analysis of diagnostic methods, including venography and ultrasound.
  • Evaluation of treatment protocols involving unfractionated heparin (UFH) and low molecular weight heparin (LMWH).

Main Results:

  • The incidence of pediatric VTE varies based on study design and diagnostic methods.
  • Central venous lines (CVLs) are the primary risk factor for VTE in pediatric patients.
  • Low molecular weight heparin (LMWH) offers advantages in administration, monitoring, bioavailability, and half-life compared to UFH.

Conclusions:

  • Pediatric VTE is a serious condition requiring careful management, with CVLs being a major risk factor.
  • LMWH is a favorable treatment option for uncomplicated pediatric VTE due to its practical advantages.
  • While death from VTE is rare, acute and long-term complications such as pulmonary embolism and postthrombotic syndrome can significantly impact children's health.

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