Clinical equipoise on prophylaxis against catheter-associated thrombosis in critically ill children

Journal of Critical Care
Candace N Mannarino, Edward Vincent S Faustino

Abstract

In preparation for a randomized controlled trial of prophylaxis against catheter-associated deep venous thrombosis in critically ill children, we aimed to determine clinical equipoise, defined as willingness to randomize children, among pediatric critical care physicians. We conducted a cross-sectional, self-administered electronic survey of pediatric critical care physicians in the United States. The survey focused on the effect of child's age, presence of a central venous catheter, and risk (ie, presence of coagulopathy or recent surgery) and presence of bleeding on their willingness to randomize children to an anticoagulant or placebo. Responses from 239 (33.0%) of 725 physicians were analyzed. Respondents were willing to randomize children 1 month or older in the presence of a catheter but only those older than 13 years in the absence of a catheter. For children with coagulopathy, they would randomize those with international normalized ratio less than or equal to 2.0, partial thromboplastin time less than or equal to 50 seconds, and platelet count greater than or equal to 50000/mm(3). Respondents were willing to randomize children 2 days after most types of surgery and after 1 to 5 days of a bleeding event. Clinical equipo...Continue Reading

References

Mar 23, 2011·The New England Journal of Medicine·Deborah CookNicholas E Vlahakis
Mar 23, 2011·Critical Care Medicine·Edward Vincent S FaustinoAdrienne G Randolph
Sep 3, 2011·Journal of Thrombosis and Haemostasis : JTH·L G MitchellUNKNOWN Perinatal and Paediatric Haemostasis Subcommittee of the SSC of the ISTH
May 19, 2012·Journal of Pediatric Surgery·Johanna R Askegard-GiesmannBrian D Kenney
Jul 3, 2013·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Ruth LebetMartha A Q Curley
May 8, 2014·Journal of Thrombosis and Haemostasis : JTH·E VidalE V S Faustino
Nov 7, 2014·Paediatric Drugs·Kim Chau, Gideon Koren

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Citations

May 6, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Edward Vincent S Faustino
Dec 30, 2020·Critical Care Medicine·E Vincent S FaustinoUNKNOWN CRETE Trial Investigators and the Pediatric Critical Care Blood Research Network (BloodNet) of the Pediatric Acute Lung Inju
Feb 23, 2021·Critical Care Medicine·Robert I Parker

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