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Epidemiology and management of massive, sub-massive, and non-massive pediatric pulmonary embolism: a systematic

Mohammed Alsabri1,2, Dina Essam Abo-Elnour3, Mohammed Ayyad4,5

  • 1Emergency Department, Al-thawara Modern General Hospital, Sana'a, Yemen. Alsabri5000@gmail.com.

BMC Pediatrics
|April 26, 2025
PubMed

Insights

This systematic review highlights that pediatric pulmonary embolism (PE) diagnosis and management vary by severity. Early diagnosis and tailored treatment are crucial for improving outcomes in children and adolescents with PE.

Area of Science:

  • Pediatric Medicine
  • Cardiology
  • Pulmonology

Background:

  • Pediatric pulmonary embolism (PE) is a critical condition with diverse presentations.
  • Understanding diagnosis, management, and outcomes is vital for this population.

Purpose of the Study:

  • To systematically review evidence on pediatric PE diagnosis, management, and outcomes.
  • To analyze presentations across massive, submassive, and non-massive severity classifications.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searches across major databases (PubMed, Scopus, Web of Science, Cochrane) up to February 2024.
  • Included studies on patients ≤21 years with confirmed PE; risk of bias assessed using NIH tool.

Main Results:

  • Six studies with 258 pediatric patients (mean age 14.1 years, predominantly female) were analyzed.
  • Common risk factors: obesity, oral contraceptives, thrombophilia, autoimmune conditions.
  • CTPA most common diagnostic tool; outcomes correlated with PE severity, with massive PE having higher mortality.

Conclusions:

  • Pediatric PE necessitates individualized risk stratification and management.
  • Diagnostic delays and severe presentations increase morbidity and mortality.
  • Future research should standardize classifications, explore novel diagnostics, and compare therapeutic interventions.
Abstract

Keywords:
Massive pulmonary embolismNon-massive pulmonary embolismPediatric pulmonary embolismSeverity classificationSubmassive pulmonary embolismSystematic review

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