SCCM Resource Library-Current and Future Practice in Pediatric Thrombosis

Video Transcription

Video Summary

The video transcript is a summary of a session on the current and future practice in pediatric thrombosis. The session covers three main topics: clinical trials in pediatric hemostasis, assessment and management of bleeding in critically ill children, and assessment, measurement, and treatment of thrombosis in pediatrics. <br /><br />The first speaker discusses clinical trials in pediatric hemostasis and anticoagulation. They highlight the increase in venous thromboembolism (VTE) in hospitalized children and the lack of effective interventions. They present the results of a pre-trial on prophylactic dosing of enoxaparin and its potential benefits in reducing the risk of catheter-associated DVT in older children. They also mention the use of direct oral anticoagulants (DOACs) in the treatment of VTE in children, although DOACs are not yet approved for pediatric use.<br /><br />The second speaker focuses on the assessment and management of bleeding in critically ill children. They introduce the Bleeding Assessment Scale in Critically Ill Children (BASIC), which was developed by experts through a modified Delphi process. The scale provides definitions for severe, moderate, and minimal bleeding in critically ill children. The speaker also mentions various hemostatic agents that can be used to control bleeding in critically ill children, although there is limited evidence for their effectiveness.<br /><br />The third speaker discusses the epidemiology and management of thrombosis in the pediatric ICU, specifically focusing on DVT, pulmonary embolism (PE), and acute ischemic stroke. They highlight the higher incidence of DVT in critically ill children, particularly those with central venous catheters, cardiac disease, or after trauma. They discuss the current guidelines for the management of pediatric DVT, including the use of anticoagulation and the removal of central venous catheters. They also mention the recommendations for the management of acute PE and acute ischemic stroke, which involve hyperacute therapies such as fibrinolysis and mechanical thrombectomy in selected cases.<br /><br />Overall, the session provides an overview of the current knowledge and practices in pediatric thrombosis, highlighting the challenges and potential interventions in the field.

Asset Subtitle

Pediatrics, Hematology, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Analyze and interpret the current guidelines for managing bleeding and thrombosis in pediatric extracorporeal life support
Assess the existing data and current recommendations for use of tissue plasminogen activator in children for acute stroke and submassive pulmonary embolism
Review and interpret data from recent pediatric clinical trials on anticoagulation and apply it to current pediatric ICU and pediatric cardiac ICU care
Discuss data and potential future uses of direct oral anticoagulants in children

Clinical Trials in Pediatric Hemostasis and Anticoagulation: How Do I Apply Trial Results in My Practice?
E. Vincent Faustino

Hemostatis: Assessment, Measurement, and Bleeding Risks
Marianne Nellis

Thrombosis: Assessment, Measurement, and Treatment
Sheila J. Hanson

Meta Tag

Content Type Presentation

Knowledge Area Pediatrics

Knowledge Area Hematology

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Anticoagulation

Tag Hemorrhage

Year 2021

Keywords

pediatric thrombosis

clinical trials

pediatric hemostasis

bleeding assessment

critically ill children

thrombosis management

venous thromboembolism

anticoagulation

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