TY - JOUR
T1 - Current approaches in the treatment of catheter-related deep venous thrombosis in children
AU - Jaffray, Julie
AU - Goldenberg, Neil
N1 - Funding Information:
N Goldenberg receives research support and salary support from the National Institutes, National Heart Lung and Blood Institute for clinical and translational investigation in venous thromboembolism in patients <21 years old; receives consultancy fees from Daiichi Sankyo Inc., Novartis, and the Academic Research Organization CPC Clinical Research for roles in clinical trial oversight committees (e.g. Steering, Data, and Safety Monitoring) in pharmaceutical industry-sponsored pediatric clinical trials of antithrombotics and other agents. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Publisher Copyright:
© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/6/2
Y1 - 2020/6/2
N2 - Introduction: Acutely ill and medically complex pediatric patients typically rely on central venous catheters (CVCs) for vascular access. CVCs can have serious complications, including venous thromboembolism (VTE). In children, CVCs are the most common risk factor for VTE. Area covered: Studies focused on the prevention and treatment of CVC-related VTE in children have been lacking until recently. Currently, there is one U.S. Food and Drug Administration (FDA) approved anticoagulant, dalteparin, and phase 3 trial results for two direct oral anticoagulants (DOACs) in pediatrics have recently been published. This review focuses on the epidemiology, risk factors, prevention, and treatment for CVC-related VTE in children. Data are included from relevant articles in PubMed, 1990 to present. Expert opinion: With a paucity of FDA-approved anticoagulants for VTE treatment or prophylaxis in children, dosing and monitoring recommendations are often based largely on adult studies. DOACs are a promising group of anticoagulants to be used for children since they are given orally and do not require monitoring. Currently, children at the highest risk for CVC-related VTE are not well represented in the published pediatric DOAC trials.
AB - Introduction: Acutely ill and medically complex pediatric patients typically rely on central venous catheters (CVCs) for vascular access. CVCs can have serious complications, including venous thromboembolism (VTE). In children, CVCs are the most common risk factor for VTE. Area covered: Studies focused on the prevention and treatment of CVC-related VTE in children have been lacking until recently. Currently, there is one U.S. Food and Drug Administration (FDA) approved anticoagulant, dalteparin, and phase 3 trial results for two direct oral anticoagulants (DOACs) in pediatrics have recently been published. This review focuses on the epidemiology, risk factors, prevention, and treatment for CVC-related VTE in children. Data are included from relevant articles in PubMed, 1990 to present. Expert opinion: With a paucity of FDA-approved anticoagulants for VTE treatment or prophylaxis in children, dosing and monitoring recommendations are often based largely on adult studies. DOACs are a promising group of anticoagulants to be used for children since they are given orally and do not require monitoring. Currently, children at the highest risk for CVC-related VTE are not well represented in the published pediatric DOAC trials.
KW - Venous thromboembolism
KW - anticoagulation
KW - central venous catheter
KW - pediatrics
KW - treatment
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U2 - 10.1080/17474086.2020.1756260
DO - 10.1080/17474086.2020.1756260
M3 - Review article
C2 - 32290724
AN - SCOPUS:85083842125
SN - 1747-4086
VL - 13
SP - 607
EP - 617
JO - Expert review of hematology
JF - Expert review of hematology
IS - 6
ER -