Life-threatening thrombotic complications in a pediatric in the intensive care unit
- Authors: Tsygankov A.E.1, Afukov I.I.2,3, Vlasovа A.V.4, Glazyrina A.A.4, Larina L.E.4, Gitinovasov R.S.1, Kurbanova S.H.4, Chudina O.S.4
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Affiliations:
- City Clinical Hospital No 40
- Filatov Children’s City Clinical Hospital
- Pirogov Russian National Research Medical University
- Morozovskaya Children’s City Clinical Hospital
- Issue: Vol 25, No 6 (2021)
- Pages: 386-391
- Section: ORIGINAL STUDY
- Submitted: 07.02.2022
- Accepted: 07.02.2022
- Published: 30.12.2021
- URL: https://jps-nmp.ru/jour/article/view/409
- DOI: https://doi.org/10.55308/1560-9510-2021-25-6-386-391
- ID: 409
Cite item
Abstract
Introduction. This article highlights the problem of thrombus formation in pediatric patients staying in ICU, namely, the problem of prevention and management of pulmonary embolism in children. Currently, there is a tendency to increasing pulmonary embolism occurrence in children, though there are no clear guidelines on the medicine dosage for the systemic thrombolytic therapy of pulmonary embolism in children and for the acute coronary syndrome in children with Kawasaki disease.
Clinical observations. The authors present two clinical cases from their practice when a successful management was obtained in children with life threatening thrombotic complications due to the applied systemic thrombolytic therapy.
Conclusion. The obtained success in the described clinical cases have resulted from a thorough analysis of ratios “risk-benefit” and “efficiency-safety”. But the authors conclude that further research work in this direction is still needed.
About the authors
A. E. Tsygankov
City Clinical Hospital No 40
Author for correspondence.
Email: tsygankovae1989@gmail.com
ORCID iD: 0000-0003-3600-2801
Alexander Е. Tsygankov, head of ICU department in infectious building
129301, Moscow
РоссияI. I. Afukov
Filatov Children’s City Clinical Hospital; Pirogov Russian National Research Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0001-9850-6779
123001, Moscow
117997, Moscow
A. V. Vlasovа
Morozovskaya Children’s City Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0001-5272-2070
119049, Moscow
РоссияA. A. Glazyrina
Morozovskaya Children’s City Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0002-2397-3484
119049, Moscow
РоссияL. E. Larina
Morozovskaya Children’s City Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0002-0735-7139
119049, Moscow
РоссияR. S. Gitinovasov
City Clinical Hospital No 40
Email: fake@neicon.ru
ORCID iD: 0000-0002-9029-4852
129301, Moscow
РоссияS. H. Kurbanova
Morozovskaya Children’s City Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0003-0509-1055
119049, Moscow
РоссияO. S. Chudina
Morozovskaya Children’s City Clinical Hospital
Email: fake@neicon.ru
119049, Moscow
РоссияReferences
- Nidhya Navanandan, Jill Stein, Rakesh D. Mistry. Pulmonary Embolism in Children. Pediatric Emergency Care. 2019; 2: 143–51. https://doi.org/10.1097/PEC.0000000000001730
- ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) 2019.
- Румянцев А.Г., Масчан А.А., Жарков П.А., Свирин П.В. Федеральные клинические рекомендации по диагностике, профилактике и лечению тромбозов у детей и подростков. М.: 2015.
- Rajpurkar M., Warrier I., Chitlur M., et al. Pulmonary embolism – experience at a single children’s hospital. Thromb Res. 2007; 119: 699–703. https://doi.org/10.1016/j.thromres.2006.05.016
- Sigrun A. Johannesdottir, Erzsébet Horváth-Puhó, Olaf M. Dekkers, Suzanne C. Cannegieter, Jens Otto L. Jørgensen, Vera Ehrenstein, Jan P. Vandenbroucke, Lars Pedersen, Henrik Toft Sørensen. Use of glucocorticoids and risk of venous thromboembolism: a nationwide populationbased case-control study. JAMA Intern Med. 2013; 173(9): 743–52. https://doi.org/10.1001/jamainternmed.2013.122
- Damien G. Noone, KazumotoIijima, Rulan Parekh. Idiopathic nephrotic syndrome in children. Lancet. 2018 Jul 7; 392(10141): 61–74. https://doi.org/10.1016/S0140-6736(18)30536-1
- Sheila J. Hanson, MD, MS, E. Vincent S. Faustino, MD, MHS, Arash Mahajerin, MD, MSCr, Sarah H. O’Brien, MD, Christian J. Streck, MD, A. Jill Thompson, Pharm D., Toni M. Petrillo, MD, John K. Petty, MD, Winston-Salem, North Carolina Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients. J Trauma Acute Care Surg. 2016 May; 80(5): 695–701.
- Horton D.B., Xie F., Chen L., Mannion M.L., Curtis J.R., Strom B.L., Beukelman T. Oral Glucocorticoids and Incident Treatment of Diabetes Mellitus, Hypertension, and Venous Thromboembolism in Children. Am J Epidemiol. 2021 Feb 1; 190(3): 403–12. https://doi.org/10.1093/aje/kwaa197. PMID: 32902632
- Lee E.Y., Tse S.K., Zurakowski D., et al. Children suspected of having pulmonary embolism: multidetector CT pulmonary angiography – thromboembolic risk factors and implications for appropriate use. Radiology. 2012; 262: 242–51. https://doi.org/10.1148/radiol.11111056
- Goudie A., Dynan L., Brady P.W., Fieldston E., Brilli R.J., Walsh K.E. Costs of venous thromboembolism, catheter-associated urinary tract infection, and pressure ulcer. Pediatrics. 2015; 136(3): 432Y9. https://doi.org/10.542/peds.2015-1386
- Albisetti M., Andrew M. Low molecular weight heparin in children. Eur J Pediatr. 2002; 161(2): 71. https://doi.org/10.007/s00431-001-0873-9
- Monagle P., Cuello C.A., Augustine C., Bonduel M., Brandão L.R., Capman T., Chan A.K.C., Hanson S., Male C., Meerpohl J., Newall F., O’Brien S.H., Raffini L., van Ommen H., Wiernikowski J., Williams S., Bhatt M., Riva J.J., Roldan Y., Schwab N., Mustafa R.A., Vesely S.K. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018 Nov 27; 2(22): 3292–316. https://doi.org/10.1182/bloodadvances.2018024786
- Gupta A.A., Leaker M., Andrew M., et al. Safety and outcomes of thrombolysis with tissue plasminogen activator for treatment of intravascular thrombosis in children. J Pediatr. 2001 Nov; 139(5): 682–8. https://doi.org/10.1067/mpd.2001.118428
- Patocka C., Nemeth J. Pulmonary embolism in pediatrics. J Emerg Med. 2012; 42: 105–16. https://doi.org/10.1016/j.jemermed.2011.03.006
- Yee D.L., Chan A.K., Williams S., et al. Varied opinions on thrombolysis forvenous thromboembolism in infants and children: findings from a survey of pediatric hematology-oncology specialists. Pediatr Blood Cancer. 2009; 53: 960–6. https://doi.org/10.1002/pbc.22146
- Corrigan J.J., Sleeth J.J., Jeter M., et al. Newborn’s fibrinolytic mechanism: components and plasmin generation. Am J Hematol. 1989; 32: 273–8. https//doi.org/10.1002/ajh.2830320407
- Williams M.D. Thrombolysis in children. Br J Haematol. 2010; 148: 26–36. https://doi.org/10.1111/j.1365-2141.2009.07914.x
- P. Monagle, A.K. Chan, N.A. Goldenberg, R.N. Ichord, J.M. Journeycake, U. NowakGottl, S.K. Vesely, P. American College of Chest, 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: e737S–801S. https://doi.org/10.1378/chest.11-2308
- Щедеркина И.О., Ларина Л.Е., Власова А.В., Лившиц М.И., Кузнецова А.А., Горбунов А.В., Харькин А.В., Селиверстова Е.В., Петряйкина Е.Е., Анжель А.Е. Возможности реперфузионной терапии при ишемическом инсульте в педиатрии: протокол тромболизиса у детей в первичном центре детского инсульта. Московская медицина. 2020; 3(37): 35Z.
- Branchford B.R., Betensky M., Goldenberg N.A. Thromb Res. Pediatric issues in thrombosis and hemostasis: The how and why of venous thromboembolism risk stratification in hospitalized children. Thromb Res. 2018 Dec; 172: 190–3. https://doi.org/10.1016/j.thromres.2018.02.010