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How I treat pediatric venous thromboembolism

Guy Young

Abstract

The incidence of pediatric venous thromboembolism (VTE) has been increasing significantly in incidence over the past decade in part as a result of increased recognition of this serious disorder but more so due to the increased use of central venous catheters and other technological advancements involved in the care of ill children. Management of pediatric VTE is a complex undertaking considering that the vast majority of children who develop this complication have serious underlying medical disorders. Although the incidence is rising, compared to adults, this remains a relatively rare disorder and as such large scale clinical trials have not been completed rendering management decisions to be based upon extrapolation from adult data and the experience of the treating physician. Clearly both are fraught with problems. Thus, day to day management remains more art than science until such time that the results from clinical trials (many of which are under way) become available. This edition of "How I Treat" will describe the author's experience in managing 3 common scenarios one may encounter in pediatric thrombosis and suggest a logical approach to such situations. Furthermore, the author provides 3 algorithms to help guide management decisions.

  • Submitted April 20, 2017.
  • Accepted July 31, 2017.