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Slow progress. How do we shift the paradigm of thinking in pediatric thrombosis and anticoagulation?

Paul Monagle1

  • 1Department of Clinical Haematology, Royal Children's Hospital, Australia; Haematology Research Murdoch Children's Research Institute, Australia; Department of Paediatrics, University of Melbourne, Flemington Rd, Melbourne, Victoria, Australia.

Thrombosis Research
|July 19, 2018
PubMed

Insights

Pediatric thrombosis diagnosis and treatment lag due to low incidence and changing hemostasis. Paradigm shifts in research and clinical thinking are needed to advance pediatric thrombosis care.

Area of Science:

  • Pediatric Hematology
  • Thrombosis Research
  • Hemostasis

Background:

  • Progress in pediatric thrombosis diagnosis, prevention, and treatment has been slow since 1994.
  • Low incidence and age-related changes in hemostasis present significant challenges in pediatric thrombosis management.
  • Current research often extrapolates adult data and methodologies, which may not be suitable for children.

Purpose of the Study:

  • To highlight the slow progress in pediatric thrombosis.
  • To identify barriers hindering advancements in the field.
  • To advocate for paradigm shifts in understanding and researching pediatric thrombosis.

Main Methods:

  • Review of existing literature and clinical observations on pediatric thrombosis.
  • Analysis of challenges in pediatric hemostasis and anticoagulant therapy.
  • Critique of current research methodologies in pediatric thrombosis.

Main Results:

  • Significant knowledge gaps persist in pediatric thrombosis diagnosis, prevention, and treatment.
  • The unique physiology of pediatric hemostasis complicates risk-benefit assessments of therapies.
  • Lack of understanding regarding thrombotic syndrome pathogenesis and natural history is a major issue.

Conclusions:

  • Advancements in pediatric thrombosis require a fundamental shift in perspective.
  • New research designs and methodologies are essential to generate robust evidence for pediatric care.
  • Addressing these paradigm shifts is crucial for improving outcomes for children with thrombosis.

Keywords:
AdolescentAnticoagulationChildrenNeonateThrombosis

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