Deep Vein Thrombosis in Severe Motor and Intellectual Disabilities Patients and Its Treatment by Anticoagulants of Warfarin Versus Edoxaban

Ohmori, Harunori; Kada, Akiko; Nakamura, Mashio; Saito, Akiko; Sanayama, Yoshitami; Shinagawa, Tomoe; Fujita, Hiroshi; Wakisaka, Akiko; Maruhashi, Keiko; Mizukami, Akiko; Takizawa, Noboru; Murata, Hiroaki; Inoue, Michiko; Kaneko, Hideo; Taniguchi, Hidekazu; Sano, Nozomi; Tanuma, Naoyuki; Kumode, Masao; Takechi, Tomoki; Koretsune, Yukihiro; Sumimoto, Ryo; Miyanomae, Takeshi

doi:10.3400/avd.oa.19-00040

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…In adult literature, cumulative incidence of DVT among patients with severe motor and intellectual disability may be as high as 8.4% and is related to altered neurovascular tone. 65,66 Children with severe motor and intellectual disability, those with chronic ventilator dependency, or spastic/flaccid cerebral palsy may be at similar risk for developing VTE.…”

Section: Patient Agementioning

confidence: 99%

Venous Thromboembolism among Critically Ill Children: A Narrative Review

Sochet

Kiskaddon

Betensky

et al. 2021

Semin Thromb Hemost

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Venous thromboembolism (VTE) is a leading cause of morbidity and mortality among hospitalized patients, including children. In recent years, it has become clear that hospitalization and critical illness bestow an increased VTE risk in pediatrics and relate to mortality and life-limiting comorbidities. For critically ill children, reported rates of VTE vary by study sampling techniques, presence of inherited or acquired thrombophilia, acute and chronic immobility, underlying illness prompting hospitalization, and clinical factors related to illness severity such as central venous catheterization, length of stay, mechanical ventilation, and patient age. Accordingly, critically ill children with new signs of venous congestion, acute inflammation, or unexplained acute organ dysfunction should be routinely evaluated for VTE. This narrative review summarizes recent and historical literature regarding risk factors, prevention, presentation, treatment, and outcomes of VTE in critically ill children. In addition, we identify knowledge gaps and priorities for future collaborative research on this vital condition. Special attention is given to the clinical trial opportunities, challenges, and ongoing efforts in thromboprophylaxis in critically ill children, including those hospitalized for disease related to novel coronavirus (COVID-19) and multisystem inflammatory disease in children.

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Section: Patient Agementioning

confidence: 99%

Venous Thromboembolism among Critically Ill Children: A Narrative Review

Sochet

Kiskaddon

Betensky

et al. 2021

Semin Thromb Hemost

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“…In previous studies, the prevalence of DVT in patients with severe motor and intellectual disabilities was 8.4%, 6 that in patients with PD was 20%, 7 and the 1‐year incidence of venous thromboembolism in patients with ALS was 11.2% 8 The prevalence of DVT in patients who underwent TPPV in our study is higher than that in patients with several common neuromuscular diseases 6‐8 and the same as that in patients with cancer who are vulnerable to DVT 9 . A trend toward an increased risk of DVT was observed with a higher rate of ventilator use in patients with Duchenne muscular dystrophy 10 .…”

Section: Discussionmentioning

confidence: 90%

Deep vein thrombosis in patients with neuromuscular disease who undergo tracheotomy with positive pressure ventilation

Yamada

Nishikawa

Yamasaki

et al. 2020

Neurology & Clinical Neurosc

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Background Deep vein thrombosis and its progression to pulmonary thromboembolism is a major source of mortality in patients with neuromuscular disease. Furthermore, ventilator use poses a high risk of DVT to patients. Methods Hospitalized patients with neuromuscular disease who underwent tracheotomy with positive pressure ventilation (TPPV) had DVT evaluated in the lower extremities by ongoing whole leg venous ultrasonography. Patients who were diagnosed with DVT underwent a second ultrasonography 1 month later. The attending physicians decided on therapeutic measures. All patients were followed during the study period. Results Eight of 33 patients had DVT. The site of DVT formation was the iliac veins in three cases, femoral veins in two cases, and calf veins in three cases. All of the patients with DVT were asymptomatic. There was no difference in the clinical future between patients with DVT and those without DVT. Progression of DVT was not observed in the second ultrasonographic examination 1 month later. All patients with DVT had an excellent prognosis after a follow‐up period of 9 months. Conclusion The prevalence of DVT in patients with neuromuscular disease who undergo TPPV might be high. Further large studies on this issue are required because the clinical significance of this DVT is uncertain.

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“…For example, CVC, a well-described HA-VTE risk factor in children (4, 25–27), may be necessary for safe medication administration, blood draws, and hemodynamic monitoring during IMV. Children receiving prolonged IMV are acutely and chronically immobilized from their underlying pathology and, at times, intentionally to ensure patient comfort, safety, and ventilator synchrony (28, 29). In our study, 66.3% of children undergoing IMV experienced acute mobility impairment, a feature we also found to be associated with HA-VTE.…”

Section: Discussionmentioning

confidence: 99%

Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children’s Hospital Acquired Thrombosis Consortium

Sochet,

Jaffray,

Branchford

et al. 2023

Pediatric Critical Care Medicine

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Objectives: To determine if the duration of invasive mechanical ventilation (IMV) was associated with hospital-acquired venous thromboembolism (HA-VTE) among critically ill children. Design: A multicenter, matched case-control study as a secondary analysis of Children’s Hospital Acquired Thrombosis (CHAT) Consortium registry. Setting: PICUs within U.S. CHAT Consortium participating centers. Patients: Children younger than 21 years old admitted to a PICU receiving IMV for greater than or equal to 1 day duration from January 2012 to March 2022 were included for study. Cases with HA-VTE were matched 1:2 to controls without HA-VTE by patient age groups: younger than 1, 1–12, and older than 12 years. Interventions: None. Measurements and Main Results: The primary outcome was IMV duration in days. Descriptive data included demographics, anthropometrics, HA-VTE characteristics (i.e., type, location, and timing), central venous catheterization data, thromboprophylaxis practices, and Braden Q mobility scores. Descriptive, comparative, and associative (multivariate conditional logistic regression for HA-VTE) statistics were employed. A total of 152 cases were matched to 304 controls. Cases with HA-VTE were diagnosed at a median of 7 days (interquartile range [IQR], 3–16 d) after IMV. The HA-VTE were limb deep venous thromboses in 130 of 152 (85.5%) and frequently central venous catheterization-related (111/152, 73%). Cases with HA-VTE experienced a longer length of stay (median, 34 d [IQR, 18–62 d] vs. 11.5 d [IQR, 6–21 d]; p < 0.001) and IMV duration (median, 7 d [IQR, 4–15 d] vs. 4 d [IQR, 1–7 d]; p < 0.001) as compared with controls. In a multivariate logistic model, greater IMV duration (adjusted odds ratio, 1.09; 95% CI, 1.01–1.17; p = 0.023) was independently associated with HA-VTE. Conclusions: Among critically ill children undergoing IMV, HA-VTE was associated with greater IMV duration. If prospectively validated, IMV duration should be included as part of prothrombotic risk stratification and future pediatric thromboprophylaxis trials.

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Deep Vein Thrombosis in Severe Motor and Intellectual Disabilities Patients and Its Treatment by Anticoagulants of Warfarin Versus Edoxaban

Cited by 8 publications

References 8 publications

Venous Thromboembolism among Critically Ill Children: A Narrative Review

Venous Thromboembolism among Critically Ill Children: A Narrative Review

Deep vein thrombosis in patients with neuromuscular disease who undergo tracheotomy with positive pressure ventilation

Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children’s Hospital Acquired Thrombosis Consortium

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