Abstract
Venous thromboembolism (VTE) is a leading cause of morbidity and preventable harm
among noncritically ill hospitalized children. Several clinical factors relevant to
the noncritically ill hospitalized child significantly increase the risk of VTE including
the presence of central venous catheters, systemic inflammation, and prolonged immobilization.
Although risk mitigation strategies have been described, the diagnosis, treatment,
and prevention of VTE require standardization of institutional practices combined
with multidisciplinary collaboration among pediatric hospitalists, hematologists,
and other care providers. In this narrative review, we summarize the epidemiology
of VTE, risk models identifying high-risk conditions associated with VTE, and prevention
and treatment strategies. We further describe successful quality improvement efforts
implementing institutional VTE risk stratification and thromboprophylaxis procedures.
Finally, we highlight unique challenges facing pediatric hospital medicine specialists
in the era of the COVID-19 pandemic, including caring for adults admitted to pediatric
hospital units, and describe future research opportunities for VTE in the noncritically
ill hospitalized child.
Keywords
thromboembolism - deep vein thrombosis - thromboprophylaxis - pediatric hospital medicine
