Clinically important venous thromboembolism in pediatric critical care: a Canadian survey.
OBJECTIVE
Pediatric venous thromboembolism (VTE) is becoming an increasingly recognized morbidity associated with critical illness. The objective of this survey is to identify the patient factors and radiological features that pediatric intensivists consider more or less likely to make a venous thrombosis (VTE) clinically important in their patients.


METHODS
Our definition of clinically important VTE was a VTE likely to result in short- or long-term morbidity or mortality if left untreated. We asked respondents to rate the likelihood that patient factors and radiological features make a venous thrombosis clinically important using a 5-point scale (1 = much less likely to 5 = much more likely).


RESULTS
The 38 (58.5%) of 65 pediatric intensivists responding rated 4 patient factors as most likely to make a VTE clinically important: clinical suspicion of pulmonary embolism (mean score, 4.8), symptoms (mean, 4.5), detection by physical exam (mean, 4.4), and the presence of an acute or chronic cardiopulmonary comorbidity that might limit a patient's ability to tolerate pulmonary embolism (mean, 4.3). Of the radiological features, the 2 considered most important were VTE involving the vena cava extending into the right atrium (mean, 5) and central veins (mean, 4.5).


CONCLUSIONS
When labeling a VTE as clinically important, pediatric intensivists rely on several specific patient factors and thrombus characteristics.
Kotsakis
Afrothite
A
Department of Critical Care, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
Cook
Deborah
D
Griffith
Lauren
L
Anton
Natalie
N
Massicotte
Patti
P
MacFarland
Kelly
K
Farrell
Rosemarie
R
Hutchison
Jamie
J
D000792:Angiography; D002170:Canada; D002648:Child; D019538:Health Care Surveys; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010818:Practice Patterns, Physicians'; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000517:prevention & control*; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000175:diagnosis / Q000517:prevention & control*