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Venous Thromboembolism
Everything in the library about venous thromboembolism — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Acute Management
1 item
VTE PPX in High Risk Trauma Patients: 2018 Pediatric Surgery Practice Gap #7
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Drs Todd Ponsky, Alex Casar, Alex Gibbons and Rae Hanke review Practice Gap #7 from 2018, as identified by APSA's Professional Development Committee.
video · Jun 2019
Evidence & Research
1 item
Quick Literature Updates Ep 21
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We’re back with 21st episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesti
video4:04 · Sep 2025
Case-Based Learning
1 item
Venous Thromboembolism Prophylaxis In Trauma Patients: Practice Gap...
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At the 6th Annual Pediatric Surgery Update Course, Drs Charles Snyder, Craig Lillehei and David Powell discussthe top ten practice gaps of 2018. Here they discuss venous thromboembolism prophylaxis in the trauma patient, focusing on VTE ris
video10:38 · Sep 2018
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Quick Literature Updates Ep 21
Pediatric trauma patients are at high risk for developing venous thromboembolism (VTE).
host_summaryLizzie Lee1:02 ↗
The Wita et al. cohort study was conducted from 2019 to 2022 in eight pediatric trauma centers and included patients younger than 18 years old.
host_summaryLizzie Lee1:09 ↗
Among 460 high-risk pediatric trauma patients, more than half received chemical VTE prophylaxis.
host_summaryLizzie Lee1:18 ↗
Delaying blood thinners beyond 24 hours of hospital arrival increases the risk of blood clots in pediatric trauma patients.
host_summaryLizzie Lee1:25 ↗
VTE prophylaxis is safe and effective for pediatric trauma patients and needs to be started within 24 hours of admission.
host_summaryLizzie Lee1:32 ↗
Gillielli et al. reviewed 104 abstracts and 34 full text articles, ultimately including 12 studies in their systematic review of female fertility cryopreservation in childhood cancer.
host_summaryAlex Halpern2:04 ↗
Ovarian tissue cryopreservation was performed in 501 pediatric cancer patients, with 5.9% undergoing ovarian tissue transplantation.
host_summaryAlex Halpern2:16 ↗
After ovarian tissue transplantation, 33% of pediatric cancer patients were able to become pregnant.
host_summaryAlex Halpern2:27 ↗
Ovarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further.
host_summaryAlex Halpern2:33 ↗
The Lee et al. systematic review and meta-analysis from Chongqing, China evaluated efficacy and long-term renal function after nephron-sparing surgery in patients with unilateral Wilms tumor.
host_summaryCecilia Gigena3:09 ↗
The meta-analysis gathered 26 studies on nephron-sparing surgery for unilateral Wilms tumor.
host_summaryCecilia Gigena3:23 ↗
Nephron-sparing surgery increased glomerular filtration rate after surgery for unilateral Wilms tumor.
host_summaryCecilia Gigena3:25 ↗
Nephron-sparing surgery showed no significant differences in overall survival, recurrences, hypertension, or renal dysfunction compared to radical nephrectomy for unilateral Wilms tumor.
host_summaryCecilia Gigena3:25 ↗
Venous Thromboembolism Prophylaxis In Trauma Patients: Practice Gap...
Pediatric surgeons historically did not routinely address VTE prophylaxis, with general teaching some time ago being that kids just didn't get this problem.
opinionTodd Ponsky0:31 ↗
Recognition of pediatric VTE has increased significantly over the last 10-20 years, possibly to the point of overuse (e.g., SCDs for 30-minute inguinal hernia repairs).
opinionTodd Ponsky0:31 ↗
The Midwest Pediatric Surgery Consortium is conducting a multi-center study (at 11 centers) of a standardized VTE prophylaxis protocol involving chemoprophylaxis with antithrombin 1A, compression devices, and daily ultrasound evaluation.
clinical2:55 ↗
The number of DVT complications in pediatric patients is very small but catastrophic when they occur.
epidemiological2:55 ↗
The vast majority of pediatric DVTs occur around central lines, and all central lines have a fibrin sheath if examined closely.
clinical3:56 ↗
The theoretically correct answer for the case is screening ultrasound on ICU day 7, because pharmacologic prophylaxis is contraindicated due to significant head bleed.
host_summaryTodd Ponsky4:37 ↗
A 2017 seminars summary by Dr. Perry (current chair of the Abstinence trauma Committee) provides a comprehensive review of pediatric VTE prophylaxis in trauma.
host_summaryTodd Ponsky4:37 ↗
VTE incidence in pediatric trauma patients is estimated between 0.16% and 1%, probably on the order of 1% or less in general.
host_summaryTodd Ponsky4:37 ↗
In adult trauma patients, VTE incidence is about 3-5%.
host_summaryTodd Ponsky4:37 ↗
In adult neuro trauma patients, VTE incidence is significantly higher at 10-15%.
host_summaryTodd Ponsky4:37 ↗
Pediatric VTE risk factors include central catheters, inflammatory bowel disease (chronic inflammatory states), blood transfusion, and obesity.
host_summaryTodd Ponsky4:37 ↗
According to the Landish schema, high-risk patients are defined as those greater than 12 years with one or more risk factors, or less than 12 years with more than 4 risk factors.
host_summaryTodd Ponsky4:37 ↗
For high-risk patients without bleeding concerns, treatment is low molecular weight heparin plus SCDs until ambulatory.
host_summaryTodd Ponsky4:37 ↗
For high-risk patients who are not candidates for pharmacologic prophylaxis, treatment is SCDs until ambulatory plus screening ultrasound on day 7.
host_summaryTodd Ponsky4:37 ↗
SCDs should be activated prior to induction of anesthesia in the operating room.
guideline8:30 ↗
The Landish article (David Gourlay's article) is probably the best protocol available for pediatric VTE prophylaxis and forms the basis for the MWPSC multi-center study.
opinion10:00 ↗
VTE PPX in High Risk Trauma Patients: 2018 Pediatric Surgery Practice Gap #7
For low bleeding risk trauma patients, the recommendation is to use SCDs and low molecular weight heparin for VTE prophylaxis.
host_summaryAlex0:00 ↗
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