APAGBI: teens 13+ should be assessed for VTE prophylaxis
Judith Morgan, MB.Ch.B., from Sheffield Children's Hospital in the United Kingdom, and colleagues reviewed the literature to provide guidance relating to the care of children in the perioperative period. The authors reviewed the incidence of perioperative VTE, risk factors, evidence for mechanical and chemical prophylaxis, and complications and detailed safe practice of regional anesthesia with anticoagulant prophylaxis.
The authors note that few areas of strong evidence were found. For young children, the risk of VTE seemed negligible, and consequently, routine prophylaxis cannot be recommended. Post-pubertal adolescents (about 13 years of age and older) have slightly elevated VTE risk, although the incidence is significantly lower than that in the adult population. These adolescents should be evaluated for prophylaxis; if other risk factors are present, intervention may be warranted.
"Although the evidence base for current practice of perioperative thromboprophylaxis in children is of low quality, we think it has been possible to bring together useful information to guide safe practice," the authors write. "We hope the decision-making algorithm and risk assessment form will be of practical use and the key recommendations will help improve the perioperative care of children."
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