In Brief | Paediatrics & Neonatology
Venous thromboembolism prophylaxis in high-risk paediatric trauma patients
Time to read: 02:01
Time to listen: 04:03
Originally Published: 31 July 2024
Sourced: JAMA Surgery
Type of article: In Brief
MedED Catalogue Reference: MPIB0024
Category: Paeadiatrics & Neonatology
Cross Reference: Emergency Medicine, Cardivascular
Keywords: multiple sclerosis, MS, psychiatry, co-morbidity, neurology
cVTE prophylaxis, when guided by defined high-risk criteria, is safe for paediatric trauma patients and does not lead to significant bleeding complications.
Originally published in JAMA Surgery, 31 July 2024. This summary does not represent original research nor is it intended to replace the original research
This prospective multi-institutional cohort study evaluated the use of chemical venous thromboembolism (cVTE) prophylaxis in high-risk pediatric trauma patients.
The following findings were recorded:
- Among the participants, 54.5% received cVTE, 13.5% of whom received it within 24 hours of admission
- A delay in cVTE administration was associated with a higher number of high-risk factors and a greater Injury Severity Score
- The primary reason for delayed cVTE was central nervous system bleeding (30.2% of cases)
- In terms of outcomes, the overall rate of VTE was 5.4%, with occurrences distributed as follows: 1.6% among those receiving cVTE within 24 hours, 6.9% in those who received treatment after 24 hours, and 5.3% for those who did not receive cVTE at all
- No bleeding complications were observed while patients received cVTE
The analysis indicated a significant association between the time to cVTE initiation and VTE risk, with each hour of delay correlating with a higher likelihood of developing VTE (odds ratio, 1.01).
Importantly, no bleeding complications were reported during the administration of vCTE.
The study concludes that cVTE prophylaxis, when guided by defined high-risk criteria, is safe for paediatric trauma patients and does not lead to significant bleeding complications.
However, delays in the initiation of cVTE are associated with increased VTE risk. Therefore, improving the timing of prophylaxis and addressing barriers to implementation may enhance the prevention of VTE in pediatric trauma patients, emphasizing the need for protocol optimization in clinical practice.
Petty J. K. (2017). Venous thromboembolism prophylaxis in the pediatric trauma patient. Seminars in pediatric surgery, 26(1), 14–20. https://doi.org/10.1053/j.sempedsurg.2017.01.001
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