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Mechanical Ventilation and Hospital-Acquired Venous Thromboembolism Among Critically Ill Children

Anthony Alexander Sochet1,2,3,4, Elizabeth Ellen Havlicek2, E Vincent S Faustino5

  • 1Divisions of Critical Care Medicine.

Hospital Pediatrics
|November 9, 2022
PubMed

Insights

Hospital-acquired venous thromboembolism (HA-VTE) occurred in 2.2% of critically ill children. Invasive mechanical ventilation (MV) independently increased the risk of HA-VTE 2.5-fold in pediatric intensive care unit (PICU) patients.

Area of Science:

  • Pediatric critical care medicine
  • Vascular medicine
  • Epidemiology

Background:

  • Hospital-acquired venous thromboembolism (HA-VTE) is a significant concern in critically ill children.
  • Invasive mechanical ventilation (MV) is a common intervention in pediatric intensive care units (PICUs).
  • The association between MV and HA-VTE in pediatric populations requires further investigation.

Purpose of the Study:

  • To estimate the occurrence of HA-VTE in children hospitalized in the PICU.
  • To evaluate the association between invasive mechanical ventilation (MV) and HA-VTE in this population.

Main Methods:

  • A multicenter, retrospective cohort study was conducted using the Pediatric Health Information Systems registry.
  • Data from 205,231 PICU encounters (January 2018–December 2019) were analyzed.
  • HA-VTE occurrence was compared between children who received MV and those who did not, using multivariable logistic regression.

Main Results:

  • The overall incidence of HA-VTE was 2.2% among critically ill children.
  • Children receiving MV had a significantly higher rate of HA-VTE (4.4%) compared to those not receiving MV (1.1%).
  • MV was independently associated with a 2.5-fold increased risk of HA-VTE (OR 2.51, 95% CI 2.33-2.69).

Conclusions:

  • HA-VTE affects 2.2% of critically ill children in the PICU.
  • Invasive mechanical ventilation is an independent risk factor for HA-VTE in this population.
  • Findings support the need for prospective studies to guide thromboprophylaxis strategies in critically ill children.
Abstract

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