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Venous Thromboembolism among Critically Ill Children: A Narrative Review

Anthony A Sochet1,2,3, Amy Kiskaddon3,4, Marisol Betensky3,5,6

  • 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Seminars in Thrombosis and Hemostasis
|May 31, 2021
PubMed

Insights

Hospitalization increases venous thromboembolism (VTE) risk in children, impacting mortality. Routine VTE evaluation is crucial for critically ill children presenting with specific symptoms.

Area of Science:

  • Pediatric critical care medicine
  • Hematology
  • Thrombosis research

Background:

  • Venous thromboembolism (VTE) is a significant cause of illness and death in hospitalized children.
  • Hospitalization and critical illness elevate VTE risk in pediatric patients, correlating with mortality and long-term health issues.
  • VTE rates in critically ill children are influenced by diverse factors including thrombophilia, immobility, and illness severity.

Purpose of the Study:

  • To review current literature on VTE in critically ill children.
  • To identify risk factors, prevention strategies, clinical presentations, treatments, and outcomes.
  • To highlight knowledge gaps and future research priorities, including COVID-19 and multisystem inflammatory disease in children.

Main Methods:

  • This narrative review synthesizes existing research on pediatric VTE.
  • It examines historical and recent literature on VTE risk, prevention, and management.
  • Focus is placed on clinical trial opportunities and challenges in thromboprophylaxis.

Main Results:

  • Critically ill children with signs of venous congestion, inflammation, or organ dysfunction require VTE assessment.
  • VTE risk is multifactorial, influenced by patient-specific and clinical factors.
  • Research into thromboprophylaxis in pediatric populations, including those with COVID-19, is ongoing.

Conclusions:

  • Early VTE evaluation is recommended for critically ill children with suggestive signs.
  • Further collaborative research is needed to address knowledge gaps in pediatric VTE.
  • Understanding and managing VTE in critically ill children is vital for improving outcomes.

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