Thromboprophylaxis in Children: Navigating Uncharted Waters

Abstract

The rising incidence of pediatric thrombosis, increasing nearly 10% annually over the past decade, underlines a need for effective preventive strategies, particularly in hospitalized children. This narrative review explores existing literature on venous thromboembolism prevention in pediatric patients to clarify current strategies in children undergoing general, orthopaedic, and Fontan surgeries, and with conditions such as acute lymphoblastic leukemia and gastrointestinal disease. While recent studies have provided some insights into potential preventive strategies, real evidence is lacking on the best practices for thromboprophylaxis in these patient groups. In the absence of substantial studies, clinicians must rely on individual assessments weighting thrombotic and bleeding risk to effectively and safely manage these “uncharted waters.”

Zusammenfassung

Die steigende Inzidenz von Thrombosen bei Kindern, die in den letzten zehn Jahren jährlich um fast 10% zugenommen hat, unterstreicht den Bedarf an wirksamen Präventionsstrategien, insbesondere bei hospitalisierten Kindern. Diese narrative Übersicht untersucht die vorhandene Literatur zur Prävention von venösen Thromboembolien bei pädiatrischen Patienten, um aktuelle Strategien für Kinder zu beleuchten, die allgemeine, orthopädische oder Fontan-Operationen durchlaufen oder an Erkrankungen wie akuter lymphoblastischer Leukämie und Magen-Darm-Erkrankungen leiden. Während neuere Studien einige Einblicke in potenzielle Präventionsstrategien bieten, fehlen jedoch aussagekräftige Belege für bewährte Praktiken der Thromboseprophylaxe in diesen Patientengruppen. In Ermangelung umfassender Studien müssen sich Ärzte auf individuelle Bewertungen verlassen, bei denen thrombotische und Blutungsrisiken abgewogen werden, um diese „unbekannten Gewässer“ effektiv und sicher zu navigieren.

Keywords

thromboprophylaxis - pediatric - surgery - acute lymphoblastic leukemia - gastrointestinal disease

Schlüsselwörter

Thromboseprophylaxe - Pädiatrie - Chirurgie - akute lymphoblastische Leukämie - gastrointestinale Erkrankung

Publication History

Received: 01 November 2024

Accepted: 26 December 2024

Article published online:
27 April 2025

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