Perioperative thromboprophylaxis in children:development of a guideline for management
PHILIP C. JACKSON MBChB FRCA AND JUDITH M. MORGAN MBChB FRCA
Pediatric Anesthesia 2008 18: 478-487
Summary
Background: Venous thromboembolic (VTE) events can occur in children at the time of surgery where a patient has associated prothrombotic risk factors. There is currently little advice available to anesthetists on how to assess the risks and provide prophylaxis. Aim/Objective: To increase awareness of thrombosis in the perioperative pediatric patient, and to give some guidance when considering prophylaxis in this group. Method/Results: A guideline outlining risk factors for venous thromboembolism in patients presenting for surgery was written as a flowchart. Recommendations for low risk patients was early mobilization and good hydration; for moderate risk patients having major general surgery to include physical prophylaxis where size permits, i.e. elastic stockings and compression devices; for high-risk patients undergoing major orthopaedic or general surgery to also receive prophylactic low molecular weight heparin enoxaparin 0.5 mg*kg−1 b.d. Conclusion: Children with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.
Keywords: venous thromboembolism; thromboprophylaxis
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