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Perioperative thromboprophylaxis in children: development of a guideline for management
Author(s) -
JACKSON PHILIP C.,
MORGAN JUDITH M.
Publication year - 2008
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2008.02597.x
Subject(s) - medicine , guideline , perioperative , compression stockings , venous thromboembolism , low molecular weight heparin , thrombosis , intermittent pneumatic compression , intensive care medicine , venous thrombosis , risk assessment , surgery , computer security , pathology , computer science
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.