Current Challenges and Advances in Pediatric Thrombosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: closed (20 July 2021) | Viewed by 15833

Special Issue Editor


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Guest Editor
IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
Interests: hemostasis and thrombosis in the pediatric population

Special Issue Information

Dear Colleagues,

The incidence of thrombosis in the pediatric population is increasing. This phenomenon is related not only to the occurrence of complications in critically ill children and neonates, but also to the increased awareness about this issue and the development of more sensitive diagnostic tools for the identification of thrombosis.

The epidemiology of VTE is very different in neonates compared with children, adolescents, and young adults.

Unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) followed by vitamin K antagonists has been the treatment of choice for most patients with VTE, with the aim of preventing thrombus extension or embolization and recurrent VTE. Patients with permanent risk factors or patients with recurrent DVT or PE require life-long secondary prevention. Over the last few years, new oral anticoagulant agents have been developed and are now undergoing extensive clinical evaluation in several settings, including the treatment of VTE. The encouraging results of the first completed clinical trials suggest that a new era in the management of VTE is beginning.

Several key issues deserve particular attention and need to be resolved in this patient population, namely: a) risk factors and patients at risk; b) the optimal diagnostic tests to perform; c) a more precise target population to screen and treat pre-emptively; and d) the role of thrombolysis.

Dr. Matteo Luciani
Guest Editor

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Keywords

  • arterial thrombosis
  • venous thrombosis
  • pediatric
  • anticoagulant

Published Papers (1 paper)

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Review

13 pages, 2267 KiB  
Review
The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis
by Dimitrios Varrias, Leonidas Palaiodimos, Prasanth Balasubramanian, Christian A Barrera, Peter Nauka, Angelos Arfaras-Melainis, Christian Zamora, Phaedon Zavras, Marzio Napolitano, Perminder Gulani, George Ntaios, Robert T. Faillace and Benjamin Galen
J. Clin. Med. 2021, 10(17), 3903; https://doi.org/10.3390/jcm10173903 - 30 Aug 2021
Cited by 14 | Viewed by 15495
Abstract
Acute lower extremity proximal deep venous thrombosis (DVT) requires accurate diagnosis and treatment in order to prevent embolization and other complications. Point-of-care ultrasound (POCUS), a clinician performed, and clinician interpreted bedside ultrasound examination has been increasingly used for DVT evaluation mainly in the [...] Read more.
Acute lower extremity proximal deep venous thrombosis (DVT) requires accurate diagnosis and treatment in order to prevent embolization and other complications. Point-of-care ultrasound (POCUS), a clinician performed, and clinician interpreted bedside ultrasound examination has been increasingly used for DVT evaluation mainly in the urgent and critical care setting, but also in the ambulatory clinics and the medical wards. Studies have demonstrated that POCUS has excellent diagnostic accuracy for acute proximal DVT when performed by well-trained users. However, there is significant heterogeneity among studies on the necessary extent of training and universally acceptable standardized education protocols are needed. In this review, we summarize the evidence that supports the use of POCUS to diagnose acute proximal DVT and focus on methodology and current technology, sensitivity and specificity, pre-test probability and the role of D-dimer, time and resources, education, limitations, and future directions. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Pediatric Thrombosis)
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