Efficacy of surveillance ultrasound for venous thromboembolism diagnosis in critically ill children after trauma

Journal of Pediatric Surgery
Rachel M LandischDavid M Gourlay

Abstract

Venous thromboembolism (VTE) is increasingly prevalent in injured children admitted to the intensive care unit (ICU). Few data exist to support VTE pharmacologic prophylaxis or ultrasound (US) surveillance in children with high bleeding risk. After implementation of screening US guidelines, we sought to describe our experience, hypothesizing that screening US of children at highest risk for VTE results in earlier detection and management. A retrospective analysis was conducted on prospectively collected data of injured children admitted to an American College of Surgeons Verified level 1 Pediatric Trauma Center from 2010 to 2015. In patients at high risk for both VTE and bleeding (HRHR), guidelines recommended deferral of pharmacologic prophylaxis and a screening US at ≥7 ICU days if bleeding risk remained. Outcomes analyzed included VTE rates, guideline compliance, and US timing. The rate of deep vein thrombosis (DVT) detection (number of DVT captured/number of US obtained) was examined. Of 4061 trauma patients, 588 (14.5%) were critically injured including 112 patients who met HRHR criteria. The rate of VTE in the HRHR group ≥7 ICU days was 25% (14/56). Of 23 VTE diagnosed in the ICU, 17 were detected by 49 US performed (34.7...Continue Reading

Citations

Jul 2, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Matthew G PintoUNKNOWN THrombosis Epidemiology in Ill Adolescents (THEIA) Study Investigators
Jan 28, 2020·Journal of Thrombosis and Haemostasis : JTH·Anjali A SharathkumarUNKNOWN SSC Subcommittee on Pediatrics and Neonatal T&H of the ISTH
Jan 20, 2021·Pediatric Surgery International·Christina GeorgeadesDavid Gourlay

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