{Reference Type}: Journal Article
{Title}: Screening and Prophylaxis for Venous Thromboembolism in Pediatric Surgery: A Systematic Review.
{Author}: Kelley-Quon LI;Acker SN;St Peter S;Goldin A;Yousef Y;Ricca RL;Mansfield SA;Sulkowski JP;Huerta CT;Lucas DJ;Rialon KL;Christison-Lagay E;Ham PB;Rentea RM;Beres AL;Kulaylat AN;Chang HL;Polites SF;Diesen DL;Gonzalez KW;Wakeman D;Baird R;
{Journal}: J Pediatr Surg
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 14
{Factor}: 2.549
{DOI}: 10.1016/j.jpedsurg.2024.05.015
{Abstract}: <B>OBJECTIVE: </B>The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee conducted a systematic review to describe the epidemiology of venous thromboembolism (VTE) in pediatric surgical and trauma patients and develop recommendations for screening and prophylaxis.<BR><B>METHODS: </B>The Medline (Ovid), Embase, Cochrane, and Web of Science databases were queried from January 2000 through December 2021. Search terms addressed the following topics: incidence, ultrasound screening, and mechanical and pharmacologic prophylaxis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available literature.<BR><B>RESULTS: </B>One hundred twenty-four studies were included. The incidence of VTE in pediatric surgical populations is 0.29% (Range = 0.1%-0.48%) and directly correlates with surgery type, transfusion, prolonged anesthesia, malignancy, congenital heart disease, inflammatory bowel disease, infection, and female sex. The incidence of VTE in pediatric trauma populations is 0.25% (Range = 0.1%-0.8%) and directly correlates with injury severity, major surgery, central line placement, body mass index, spinal cord injury, and length-of-stay. Routine ultrasound screening for VTE is not recommended. Consider sequential compression devices in at-risk nonmobile, pediatric surgical patients when an appropriate sized device is available. Consider mechanical prophylaxis alone or with pharmacologic prophylaxis in adolescents >15 y and post-pubertal children <15 y with injury severity scores >25. When utilizing pharmacologic prophylaxis, low molecular weight heparin is superior to unfractionated heparin.<BR><B>CONCLUSIONS: </B>While VTE remains an infrequent complication in children, consideration of mechanical and pharmacologic prophylaxis is appropriate in certain populations.<BR><B>METHODS: </B>Systematic Review of level 2-4 studies.<BR><B>METHODS: </B>Level 3-4.