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Thrombosis incidence in major paediatric burns
Ashlee Kimball1, Edward Gibson1, Linda Quinn1
1Burns Service, Women's and Children's Health Network, North Adelaide, South Australia, Australia.
ANZ Journal of Surgery
|September 8, 2023
Summary
Major pediatric burns significantly increase thrombosis risk, especially with extensive burns and central venous catheters (CVCs). Targeted thromboprophylaxis may be necessary for prevention in these vulnerable patients.
Area of Science:
- Pediatric critical care medicine
- Burn injury management
- Thrombosis and hemostasis
Background:
- Major burns present unique thrombosis risks in children, differing from adults.
- Lack of established guidelines for thromboprophylaxis in pediatric burn patients.
- Investigating thrombosis risk factors in major pediatric burns is crucial.
Purpose of the Study:
- To examine the incidence of thrombotic events in major pediatric burns.
- To identify risk factors associated with thrombosis in this population.
- To inform the development of prevention guidelines.
Main Methods:
- Retrospective cohort study of pediatric burn patients with % total body surface area (TBSA) ≥30%.
- Data collected over 16 years from Adelaide Women's and Children's Hospital.
- Involved review of coding data, local burns database, and case files.
Main Results:
- Six out of 23 patients (26%) experienced thrombotic events.
- Thrombotic events strongly associated with extensive burns (average 68.5% TBSA).
- Most events (5/6) were linked to central venous catheters (CVCs), with one deep venous thrombosis (DVT).
Conclusions:
- Significant incidence of thrombotic events observed in major pediatric burns.
- Large %TBSA and CVCs are key risk factors for thrombosis.
- Screening and targeted thromboprophylaxis are recommended for major pediatric burn patients.
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