Thrombosis: Clinical Resources/Guidelines

Listed are some clinical resources that we believe may be useful to healthcare practitioners.

Epidemiology and outcomes of clinically unsuspected venous thromboembolism in children: A systematic review

J Thromb Haemost. 2020; 18: 1100– 1112.

DOI: 10.1111/jth.14739

 

A systematic review on unsuspected venous thromboembolism in children. Clinical uVTE outcomes were general favorable, but still required future clinical study to clarify optimal treatment approach.

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The identification of at‐risk patients and prevention of venous thromboembolism in pediatric cancer: guidance from the SSC of the ISTH

J Thromb Haemost 2018; 16: 175–80. 
DOI: 10.1111/jth.13895

 

This is a guidance article to identify pediatric cancer patients who are at risk of venous thrombosis for consideration of prophylaxis. There is still a lot to be learned about prophylaxis in patients with pediatric cancer including some clinical trials that have been published and others which are in progress.

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ASH Guidelines (2018)

Blood Adv (2018) 2 (22): 3292–3316.

DOI: 10.1182/bloodadvances.2018024786

 

Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism published by the American Society of Hematology in 2018.

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Consensus Statements on the Risk, Prevention, and Treatment of Venous Thromboembolism in Inflammatory Bowel Disease: Canadian Association of Gastroenterology

Gastroenterology 2014; 146(3): 835-848.
DOI: 10.1053/j.gastro.2014.01.042


Most statements in this consensus guideline on recommendations for the management of VTE in patients with inflammatory bowel disease.

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Recommendations for future research in relation to pediatric pulmonary embolism: communication from the SSC of the ISTH

J Thromb Haemost. 2018 Feb;16(2):405-408. 
DOI: 10.1111/jth.13902

This communication from the ISTH SSC highlights recent knowledge on pulmonary embolism in children and provides recommendations for future research.

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Recommendations for the development of new anticoagulant drugs for pediatric use: communication from the SSC of the ISTH

 Thromb Haemost 2015; 13: 481-484. 
DOI: 10.1111/jth.12807
 

This communication provides a framework for the development of new antithrombotic therapies in children.

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Recommendations for the assessment of non‐extremity venous thromboembolism outcomes: communication from the SSC of the ISTH

J Thromb Haemost 2015; 13: 477-480. 
DOI: 10.1111/jth.12809


This communication provides guidance on the follow-up of pediatric patients with non-extremity venous thromboembolism (not including stroke)

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Recommendations for the development of a dedicated pediatric anticoagulation service: communication from the SSC of the ISTH

J Thromb Haemost 2015; 13: 155-159. 
DOI: 10.1111/jth.12763


This communication provides guidance on how one can develop an anticoagulation service so that the outcome of children with thromboembolism can be improved.

9

Definition of clinical efficacy and safety outcomes for clinical trials in deep venous thrombosis and pulmonary embolism in children

J Thromb Haemost 2011; 9(9): 1856–1858.
DOI: 10.1111/j.1538-7836.2011.04433.x


Definition of efficacy and safety outcome is important when we design clinical trials in the area.

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Recommendations for point-of-care home international normalized ratio testing in children on vitamin K antagonist therapy

J Thromb Haemost 2013; 11: 366–9.
DOI: 10.1111/jth.12089


Despite development of new oral anticoagulants, vitamin K antagonist would be required by some patients requiring thromboprophylaxis. These recommendations will help develop point-of-care monitoring to provide more autonomy to patients and family.

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Recommendations for measuring health-related quality of life in children on anticoagulation

J Thromb Haemost 2012; 10: 2596–2598.
DOI: 10.1111/jth.12018


Recommendations regarding quality of life measurements in managing children with venous thromboembolism and using QoL as outcome measures in clinical trials.

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Standardization of post-thrombotic syndrome definition and outcome assessment following upper venous system thrombosis in pediatric practice

J Thromb Haemost 2012; 10: 2182–2185. 
DOI: 10.1111/j.1538-7836.2012.04885.x


Post-thrombotic syndrome is an important outcome measure and this communication gives recommendations on assessment of PTS in upper venous system thrombosis.

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Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

Chest 2012; 141(2): e737S-e801S

DOI: 10.1378/chest.11-2308


The last guideline on antithrombotic therapy in neonates and children by the American College of Chest Physicians and will not be updated.

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Definition of post-thrombotic syndrome following lower extremity deep venous thrombosis and standardization of outcome measurement in pediatric clinical investigations

J Thromb Haemost 2011; 10: 477–480.
DOI: 10.1111/j.1538-7836.2011.04594.x


Post-thrombotic syndrome is an important outcome measure and this communication gives recommendations on assessment of PTS in lower venous system thrombosis.

15

Recommendations for developing uniform laboratory monitoring of heparinoid anticoagulants in children

J Thromb Haemost 2011; 10: 145–147.
DOI: 10.1111/j.1538-7836.2011.04561.x


This statement is a must read for anyone responsible for managing heparinoid anticoagulants in children.

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Developmental hemostasis: recommendations for laboratories reporting pediatric samples

J Thromb Haemost 2011; 10: 298–300.
DOI: 10.1111/j.1538-7836.2011.04584.x


This communication sets the standard to how pediatric samples should be reported on coagulation protein and coagulation inhibitors. The challenges remain to establish “population‐, reagent‐ and analyzer‐specific reference ranges.” according to standard.

UpToDate Chapters

Management of thrombosis in the newborn

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Venous thrombosis and thromboembolism in children: Risk factors, clinical manifestations, and diagnosis

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Venous thrombosis and thromboembolism in children: Treatment, prevention, and outcome

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Thromboembolism in children with cancer