Perioperative thromboprophylaxis in children: development of a guideline for management.
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.


OBJECTIVE
To increase awareness of thrombosis in the perioperative pediatric patient, and to give some guidance when considering prophylaxis in this group.


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 x kg(-1) b.d.


CONCLUSIONS
Children with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.
Jackson
Philip C
PC
Anaesthetic Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, UK.
Morgan
Judith M
JM
D000293:Adolescent; D000776:Anesthesiology / Q000592:standards*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019990:Perioperative Care; D017410:Practice Guidelines as Topic / Q000592:standards*; D018570:Risk Assessment / Q000145:classification / Q000379:methods; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*