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Pulmonary embolism in pediatrics: A 10-year experience from a tertiary center in Brazil

Liana Ariel de Siqueira Lira1, Daniele Martins Celeste1, Marlene Pereira Garanito1

  • 1Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Hematology, Transfusion and Cell Therapy
|April 11, 2022
PubMed

Insights

Pediatric pulmonary embolism (PE) is increasing, with risk factors like central venous catheters and malignancy common. Early diagnosis and treatment are crucial for positive outcomes in children.

Area of Science:

  • Pediatric Medicine
  • Cardiology
  • Hematology

Background:

  • Pulmonary embolism (PE) in children is increasingly recognized but remains underdiagnosed.
  • Limited data exists on pediatric PE, hindering standardized prophylaxis and diagnosis.
  • This study addresses the incidence, characteristics, and management of PE in pediatric patients in Brazil.

Purpose of the Study:

  • To determine the incidence of pediatric PE at a Brazilian tertiary hospital.
  • To describe the clinical characteristics and identify risk factors for pediatric PE.
  • To analyze the diagnostic and management strategies for pediatric PE.

Main Methods:

  • Retrospective review of pediatric patients (0-18 years) diagnosed with acute PE.
  • Data collected from a single tertiary Brazilian center over a 10-year period (September 2009 - May 2019).
  • Radiological diagnosis of acute pulmonary embolism was the primary inclusion criterion.

Main Results:

  • The incidence of PE was 3.3 cases per 10,000 hospitalized children.
  • All 23 pediatric PE cases had at least one risk factor, most commonly central venous catheter (39.1%), malignancy (34.8%), and recent surgery (34.8%).
  • Dyspnea was the most frequent symptom (56.2%); 70.6% of patients received 3-6 months of antithrombotic therapy, with most showing thrombosis resolution.

Conclusions:

  • The observed incidence may be lower than actual due to underdiagnosis linked to low clinical suspicion.
  • Identifying risk factors in all patients underscores the need for heightened awareness in high-risk children.
  • Prompt diagnosis and management of pediatric PE are essential for favorable outcomes.
Abstract

Keywords:
AdolescentChildPulmonary embolismThromboembolism

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