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Perioperative thromboprophylaxis in children: development of a guideline for management

Philip C Jackson1, Judith M Morgan

  • 1Anaesthetic Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, UK.

Paediatric Anaesthesia
|May 1, 2008
PubMed

Insights

Perioperative venous thromboembolism (VTE) in children requires risk assessment. Prophylaxis guidelines are provided for surgical patients with prothrombotic risk factors, ranging from mobilization to anticoagulation.

Area of Science:

  • Pediatric surgery
  • Anesthesiology
  • Hematology

Background:

  • Venous thromboembolic (VTE) events pose a risk to pediatric surgical patients with prothrombotic factors.
  • Limited guidance exists for anesthetists on VTE risk assessment and prophylaxis in this population.

Purpose of the Study:

  • To enhance awareness of perioperative thrombosis in children.
  • To provide guidance on VTE prophylaxis for pediatric surgical patients.

Main Methods:

  • A flowchart guideline was developed to outline VTE risk factors in surgical patients.
  • Recommendations were stratified based on patient risk levels (low, moderate, high).

Main Results:

  • Low-risk patients: early mobilization and hydration.
  • Moderate-risk patients (major general surgery): physical prophylaxis (e.g., elastic stockings).
  • High-risk patients (major orthopedic/general surgery): prophylactic low molecular weight heparin (enoxaparin 0.5 mg/kg twice daily).

Conclusions:

  • Pediatric patients with multiple VTE risk factors undergoing prolonged major surgery should be considered for prophylactic measures.
Abstract

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