Abstract
Given the increased incidence of venous thromboembolism (VTE) in pediatric patients, which has been associated with increased survival of medically complex patients and increased use of invasive supportive measures, it is important to understand treatment options and unique aspects of anticoagulant use in children. The objective of this mini-review is to outline the goals of treatment, treatment options, and adverse events associated with the use of anticoagulants in pediatric patients with VTE.
Highlights
Venous thromboembolism (VTE), especially hospital-acquired VTE, is increasingly recognized in pediatric patients
When considering treatment options in children, it is important to consider ways in which use of anticoagulants in pediatric patients may differ from adults
As outlined in the American College of Chest Physicians CHEST Guidelines for “Antithrombotic Therapy in Neonates and Children,” some of these important differences include [1] “epidemiology of thromboembolism in pediatric patients differs from that seen in adults,” [2] “hemostatic system is a dynamic, evolving entity that likely affects the frequency and natural history of thromboembolism in children and the response to therapeutic agents,” [3] “distribution, binding, and clearance of antithrombotic drugs are age dependent,” [4] “limited vascular access reduces the ability to effectively deliver some antithrombotic therapies and can influence the choice of antithrombotic agent,” [5] “specific pediatric formulations of antithrombotic drugs are not available, making accurate, reproducible dosing difficult,” and [6] “dietary differences make the use of oral vitamin k antagonists difficult” [2]
Summary
Reviewed by: Stacy Croteau, Boston Children’s Hospital, USA Anupama Narla, Stanford University, USA. Treatment of Venous Thromboembolism in Pediatric Patients. Given the increased incidence of venous thromboembolism (VTE) in pediatric patients, which has been associated with increased survival of medically complex patients and increased use of invasive supportive measures, it is important to understand treatment options and unique aspects of anticoagulant use in children. The objective of this mini-review is to outline the goals of treatment, treatment options, and adverse events associated with the use of anticoagulants in pediatric patients with VTE
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