Pharmacist antithrombotic interventions in critically ill children: A multicenter prospective study.

Area of Science:

• Pediatric critical care medicine
• Pharmacology
• Thrombosis management

Background:

• Antithrombotic therapy is vital for critically ill adults, but data in pediatric populations are scarce.
• Pediatric pharmacists' role in managing complex medication regimens is increasingly recognized.
• Understanding antithrombotic interventions in pediatric intensive care is crucial for optimizing patient care.

Purpose of the Study:

• To characterize the types of antithrombotic therapy interventions performed by pediatric pharmacists.
• To identify the settings and patient populations receiving these interventions.
• To establish a baseline for future research on pharmacist-led antithrombotic management in pediatrics.

Main Methods:

• A multicenter, prospective, observational study was conducted across 9 US children's hospitals.
• Pediatric pharmacists recorded antithrombotic interventions during clinical activities over at least 20 shifts each.
• Data were collected in a central REDCap database, and descriptive statistics were used for analysis.

Main Results:

• Over 12,000 interventions were recorded for over 2,000 patients.
• Antithrombotic interventions accounted for 9% of all interventions, involving 26.4% of patients.
• Most antithrombotic interventions (74.7%) occurred in pediatric cardiac intensive care units (PCICUs) and primarily involved anticoagulation (90.4%).

Conclusions:

• The majority of antithrombotic interventions in critically ill children were in PCICUs, focusing on anticoagulation for thromboembolism.
• Pediatric pharmacists are actively involved in managing antithrombotic therapy in critically ill children.
• Further research is recommended to evaluate the impact of pediatric pharmacist-driven services on antithrombotic outcomes, especially in cardiac patients.