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How I treat pediatric pulmonary embolism
Ayesha Zia1, Neil A Goldenberg2,3, Madhvi Rajpurkar4,5
1Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
Blood
|July 11, 2025
Summary
Pediatric pulmonary embolism (PE) is rising, particularly in adolescents. Advances in risk prediction, anticoagulation trials, and understanding long-term effects are improving management, though questions remain.
Area of Science:
- Pediatric Hematology
- Cardiovascular Medicine
- Clinical Research
Background:
- Venous thromboembolism (VTE) affects 1 in 200 hospitalized children.
- Diagnoses of pulmonary embolism (PE), a severe VTE form, have increased by 200% in two decades, especially in adolescents.
- Pediatric PE management is highly variable, necessitating updated clinical guidelines.
Purpose of the Study:
- To review recent advances in pediatric PE management and research over the past decade.
- To highlight shifts in clinical practice, including PE Response Teams and multidisciplinary decision-making.
- To discuss progress in anticoagulation therapy, post-PE syndrome understanding, and future research needs.
Main Methods:
- Review of published studies on pediatric PE within the last 10 years.
- Analysis of clinical trials on anticoagulation in children and adolescents.
- Examination of research on post-PE syndrome and management strategies.
Main Results:
- Implementation of pediatric PE Response Teams and multidisciplinary approaches for severe cases.
- Completion of clinical trials for pediatric anticoagulation and ongoing research into optimal therapy duration.
- Advancements in understanding and evaluating post-PE syndrome.
Conclusions:
- Significant progress has been made in pediatric PE diagnosis and management.
- Continued research is crucial to address remaining questions and refine treatment protocols.
- Multidisciplinary care and evidence-based guidelines are essential for improving outcomes in pediatric PE.
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