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Epidemiology of Lower Extremity Deep Venous Thrombosis in Critically Ill Adolescents.
Faustino, Edward Vincent S; Shabanova, Veronika; Pinto, Matthew G; Li, Simon; Trakas, Erin; Miksa, Michael; Gertz, Shira; Polikoff, Lee A; Napolitano, Massimo; Brudnicki, Adele R; Tala, Joana A; Silva, Cicero T.
Afiliação
  • Faustino EVS; Department of Pediatrics, Yale School of Medicine, New Haven, CT. Electronic address: vince.faustino@yale.edu.
  • Shabanova V; Department of Pediatrics, Yale School of Medicine, New Haven, CT.
  • Pinto MG; Department of Pediatrics, New York Medical College, Valhalla, NY.
  • Li S; Department of Pediatrics, New York Medical College, Valhalla, NY.
  • Trakas E; Department of Pediatrics, University of Rochester Golisano Children's Hospital, Rochester, NY.
  • Miksa M; Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY.
  • Gertz S; Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ.
  • Polikoff LA; Department of Pediatrics, The Warren Alpert School of Medicine at Brown University, Providence, RI.
  • Napolitano M; Department of Diagnostic Radiology, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ.
  • Brudnicki AR; Department of Diagnostic Radiology, New York Medical College, Valhalla, NY.
  • Tala JA; Pediatric Intensive Care Unit, Yale-New Haven Children's Hospital, New Haven, CT.
  • Silva CT; Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT.
J Pediatr ; 201: 176-183.e2, 2018 10.
Article em En | MEDLINE | ID: mdl-29891258
OBJECTIVE: To determine the epidemiology of lower extremity deep venous thrombosis (DVT) in critically ill adolescents, which currently is unclear. STUDY DESIGN: We performed a multicenter, prospective, cohort study. Adolescents aged 13-17 years who were admitted to 6 pediatric intensive care units and were anticipated to receive cardiopulmonary support for at least 48 hours were eligible, unless they were admitted with DVT or pulmonary embolism or were receiving or anticipated to receive therapeutic anticoagulation. While patients were in the unit, serial sonograms of the lower extremities were performed, then centrally adjudicated. Bayesian statistics were used to leverage the similarities between adults and adolescents. RESULTS: A total of 88 adolescents were enrolled, from whom 184 lower extremity sonograms were performed. Of these, 9 adolescents developed DVT, with 1 having bilateral DVT. The frequency of DVT was 12.4% (95% credible interval: 6.1%, 20.1%), which ranged from 6.3% to 19.8% with a variability of 41.0% across units. All cases of DVT occurred in adolescents who received invasive mechanical ventilation (frequency: 16.5%; 95% credible interval 8.1%, 26.6%). DVT was associated with femoral central venous catheterization (OR 15.44; 95% credible interval 1.62, 69.05) and severe illness (OR for every 0.1 increase in risk of mortality 3.11; 95% credible interval 1.19, 6.85). DVT appears to be associated with prolonged days on support. CONCLUSIONS: Our findings highlight the similarities and differences in the epidemiology of DVT between adults and adolescents. They support the conduct and inform the design of a trial of pharmacologic prophylaxis in critically ill adolescents.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Estado Terminal / Medição de Risco / Trombose Venosa / Extremidade Inferior Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Trombolítica / Estado Terminal / Medição de Risco / Trombose Venosa / Extremidade Inferior Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos