{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:21:33Z","timestamp":1788808893392,"version":"build-2803163510"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Venous thromboembolism (VTE) in children is a rare but serious event. Current guidance on pharmacological thromboprophylaxis in children is mostly based on adult studies and expert opinions. The aim of this systematic review was to examine under which conditions children (age \u2264 18 years) would benefit from pharmacological thromboprophylaxis with low molecular weight heparin or unfractionated heparin. Eligible studies included children, who did not receive pharmacological thromboprophylaxis as comparator, and VTE events were radiologically verified. MEDLINE and Embase were searched up to October 3, 2021. Ten studies were included presenting data for 976 children receiving pharmacological thromboprophylaxis. We divided the studies into three categories based on the population studied: children in the intensive care unit (n\u2009=\u20092), children with fractures and\/or undergoing surgery (n\u2009=\u20095), and children with systemic disease (n\u2009=\u20093). A lower incidence of VTE was found when pharmacological thromboprophylaxis was used compared with no prophylaxis in children in intensive care unit with central venous catheter and mechanical ventilation (7\/27 vs. 13\/24), children in the intensive care unit admitted after trauma with a very high risk of VTE based on several risk factors (0\/21 vs. 13\/96), and children with acute lymphoblastic leukemia treated with L-asparaginase concomitant with steroid and presence of central venous catheter (0\/82 vs. 8\/121). Pharmacological thromboprophylaxis was not associated with an increased bleeding risk. In conclusion, pharmacological thromboprophylaxis in children is sparsely investigated. Only children with several risk factors for VTE are likely to benefit from pharmacological thromboprophylaxis.<\/jats:p>","DOI":"10.1055\/s-0042-1748151","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T18:30:26Z","timestamp":1656613826000},"page":"413-421","source":"Crossref","is-referenced-by-count":10,"title":["Prophylaxis of Venous Thromboembolism in Children: A Systematic Review"],"prefix":"10.1055","volume":"48","author":[{"given":"Lotte Hejberg","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Faculty of Health, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitte Bonde","family":"Villadsen","sequence":"additional","affiliation":[{"name":"Faculty of Health, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Hellfritzsch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup 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Pediatr"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1203\/00006450-200006000-00013","article-title":"Outcome of pediatric thromboembolic disease: a report from the Canadian Childhood Thrombophilia Registry","volume":"47","author":"P Monagle","year":"2000","journal-title":"Pediatr Res"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.3324\/haematol.2010.026989","article-title":"Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors","volume":"95","author":"N A Goldenberg","year":"2010","journal-title":"Haematologica"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1542\/peds.2009-0768","article-title":"Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007","volume":"124","author":"L Raffini","year":"2009","journal-title":"Pediatrics"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/MPH.0b013e3182134111","article-title":"Venous thromboembolism in pediatric patients: epidemiologic data from a pediatric tertiary care center in Alabama","volume":"33","author":"J M Wright","year":"2011","journal-title":"J Pediatr Hematol Oncol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/pbc.23388","article-title":"Pediatric venous thromboembolism in the United States: a tertiary care complication of chronic diseases","volume":"59","author":"B A Setty","year":"2012","journal-title":"Pediatr Blood Cancer"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/S2352-3026(19)30219-4","article-title":"Rivaroxaban compared with standard anticoagulants for the treatment of acute venous thromboembolism in children: a randomised, controlled, phase 3 trial","volume":"7","author":"C Male","year":"2020","journal-title":"Lancet Haematol"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1182\/bloodadvances.2017013292","article-title":"Increasing rate of pulmonary embolism diagnosed in hospitalized children in the United States from 2001 to 2014","volume":"2","author":"S L Carpenter","year":"2018","journal-title":"Blood Adv"},{"key":"ref10","first-page":"149","volume-title":"Venous Thromboembolic Disease in Children and Adolescents","author":"V C Radulescu","year":"2017"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e195S","DOI":"10.1378\/chest.11-2296","article-title":"Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"S R Kahn","year":"2012","journal-title":"Chest"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"e227S","DOI":"10.1378\/chest.11-2297","article-title":"Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"M K Gould","year":"2012","journal-title":"Chest"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e278S","DOI":"10.1378\/chest.11-2404","article-title":"Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Y Falck-Ytter","year":"2012","journal-title":"Chest"},{"issue":"01","key":"ref14","first-page":"165","article-title":"Development of the human coagulation system in the full-term infant","volume":"70","author":"M Andrew","year":"1987","journal-title":"Article Blood"},{"issue":"08","key":"ref15","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1182\/blood.V80.8.1998.1998","article-title":"Maturation of the hemostatic system during childhood","volume":"80","author":"M Andrew","year":"1992","journal-title":"Blood"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jpeds.2004.06.021","article-title":"Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey","volume":"145","author":"P D Stein","year":"2004","journal-title":"J Pediatr"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1182\/blood.V83.5.1251.1251","article-title":"Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE","volume":"83","author":"M Andrew","year":"1994","journal-title":"Blood"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jpeds.2011.03.052","article-title":"Pediatric venous and arterial noncerebral thromboembolism in Denmark: a nationwide population-based study","volume":"159","author":"R Tuckuviene","year":"2011","journal-title":"Article J Pediatr"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2007.02450.x","article-title":"Incidence and mortality of venous thrombosis: a population-based study","volume":"5","author":"I A Naess","year":"2007","journal-title":"J Thromb Haemost"},{"issue":"12","key":"ref20","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1056\/NEJMra1700365","article-title":"Thrombophilia testing and venous thrombosis","volume":"377","author":"J M Connors","year":"2017","journal-title":"Review N Engl J Med"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1365-2141.2010.08543.x","article-title":"Guideline on the investigation, management and prevention of venous thrombosis in children","volume":"154","author":"E Chalmers","year":"2011","journal-title":"Article Br J Haematol"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1038\/sj.bjp.0707447","article-title":"Pharmacokinetics, efficacy, and safety of LMWHs in venous thrombosis and stroke in neonates, infants and children","volume":"153","author":"U Nowak-G\u00f6ttl","year":"2008","journal-title":"Br J Pharmacol"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000004784","article-title":"Efficacy of early prophylaxis against catheter-associated thrombosis in critically ill children: a Bayesian phase 2b randomized clinical trial","author":"E VS Faustino","year":"2020","journal-title":"Crit Care Med"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0049-3848(03)00099-9","article-title":"An open-label randomized controlled trial of low molecular weight heparin for the prevention of central venous line-related thrombotic complications in children: the PROTEKT trial","volume":"109","author":"P Massicotte","year":"2003","journal-title":"Thromb Res"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.jtcvs.2019.06.015","article-title":"High-dose heparin is associated with higher bleeding and thrombosis rates in pediatric patients following cardiac surgery","volume":"158","author":"C N Vorisek","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"29","key":"ref29","doi-asserted-by":"crossref","first-page":"e16552","DOI":"10.1097\/MD.0000000000016552","article-title":"Is pharmacological anticoagulant prophylaxis necessary for adolescent idiopathic scoliosis surgery?","volume":"98","author":"A Kochai","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.wneu.2017.05.050","article-title":"Prevention of thromboembolic complications after spine surgery by the use of low-molecular-weight heparin","volume":"104","author":"X J Zeng","year":"2017","journal-title":"Article World Neurosurg"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/BPO.0b013e31824b2a07","article-title":"The role of clinically significant venous thromboembolism and thromboprophylaxis in pediatric patients with pelvic or femoral fractures","volume":"32","author":"L J Greenwald","year":"2012","journal-title":"J Pediatr Orthop"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/pbc.21222","article-title":"Comparison of low-molecular-weight heparin and antithrombin versus antithrombin alone for the prevention of symptomatic venous thromboembolism in children with acute lymphoblastic leukemia","volume":"50","author":"B Meister","year":"2008","journal-title":"Pediatr Blood Cancer"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/00001721-200107000-00005","article-title":"Prophylactic therapy with enoxaparin during L-asparaginase treatment in children with acute lymphoblastic leukemia","volume":"12","author":"R Elhasid","year":"2001","journal-title":"Article Blood Coagul Fibrinolysis"},{"issue":"12","key":"ref34","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1097\/PCC.0000000000001743","article-title":"Analysis of patient characteristics and risk factors for thrombosis after surgery for congenital heart disease","volume":"19","author":"L D Murphy","year":"2018","journal-title":"Pediatr Crit Care Med"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1160\/TH03-02-0091","article-title":"Significant association with location of central venous 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thrombotic and haemostatic issues in paediatric malignancy","volume":"180","author":"K R Sibson","year":"2018","journal-title":"Article Br J Haematol"},{"issue":"06","key":"ref39","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s00383-020-04855-1","article-title":"Venous thromboembolism prophylaxis after pediatric trauma","volume":"37","author":"C Georgeades","year":"2021","journal-title":"Pediatr Surg Int"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1016\/j.otsr.2019.05.026","article-title":"Thrombotic risk in children undergoing orthopedic surgery","volume":"106","author":"T Odent","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"issue":"01","key":"ref41","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1001\/jamasurg.2015.2670","article-title":"A clinical tool for the prediction of venous thromboembolism in pediatric trauma patients","volume":"151","author":"C R Connelly","year":"2016","journal-title":"JAMA Surg"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1080\/08880018.2019.1695030","article-title":"Development of a perioperative venous thromboembolism prophylaxis algorithm for pediatric orthopedic surgical patients","volume":"37","author":"K Padhye","year":"2020","journal-title":"Pediatr Hematol Oncol"},{"issue":"01","key":"ref43","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1542\/hpeds.2014-0044","article-title":"Venous thromboembolism in hospitalized adolescents: an approach to risk assessment and prophylaxis","volume":"5","author":"K A Meier","year":"2015","journal-title":"Review Hosp Pediatr"},{"issue":"05","key":"ref44","first-page":"e1326","article-title":"Thromboprophylaxis in a pediatric hospital: a patient-safety and quality-improvement initiative","volume":"127","author":"L Raffini","year":"2011","journal-title":"Article Pediatrics"},{"issue":"12","key":"ref45","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1542\/hpeds.2014-0241","article-title":"Development and implementation results of a venous thromboembolism prophylaxis guideline in a tertiary care pediatric hospital","volume":"5","author":"A Mahajerin","year":"2015","journal-title":"Article Hosp Pediatr"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1097\/TA.0b013e31824964d1","article-title":"Effectiveness of clinical guidelines for deep vein thrombosis prophylaxis in reducing the incidence of venous thromboembolism in critically ill children after trauma","volume":"72","author":"S J Hanson","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"issue":"08","key":"ref47","first-page":"1045","article-title":"Hospital-associated venous thromboembolism in pediatrics: a systematic review and meta-analysis of risk factors and risk-assessment models","volume":"100","author":"A 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Database Syst Rev"},{"issue":"07","key":"ref51","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1111\/jth.12598","article-title":"Central venous catheter-related thrombosis and thromboprophylaxis in children: a systematic review and meta-analysis","volume":"12","author":"E Vidal","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref52","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/PCC.0b013e318207124a","article-title":"Incidence and risk factors associated with venous thrombotic events in pediatric intensive care unit patients","volume":"12","author":"R A Higgerson","year":"2011","journal-title":"Pediatr Crit Care Med"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/CCM.0000000000000147","article-title":"A multinational study of thromboprophylaxis practice in critically ill children","volume":"42","author":"E V Faustino","year":"2014","journal-title":"Crit Care Med"},{"issue":"05","key":"ref54","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/TA.0000000000000962","article-title":"Recommendations for venous thromboembolism prophylaxis in pediatric trauma patients: a national, multidisciplinary consensus study","volume":"80","author":"S J Hanson","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"issue":"24","key":"ref55","doi-asserted-by":"crossref","first-page":"2622","DOI":"10.1161\/01.cir.0000436140.77832.7a","article-title":"Prevention and treatment of thrombosis in pediatric and congenital heart disease: a scientific statement from the American Heart Association","volume":"128","author":"T M Giglia","year":"2013","journal-title":"Article Circulation"}],"container-title":["Seminars in Thrombosis and 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