Epidemiology of Bleeding in Critically Ill Children

Protein biomarkers for incident deep venous thrombosis in critically ill adolescents: An exploratory study

“…The severity of each bleeding event was assessed based on the definitions of the International Society on Thrombosis and Hemostasis . For purposes of the THEIA study, a clinically relevant bleeding included events that were fatal, hemoglobin decreased ≥2 g/dL in 24 hours, required medical or surgical intervention for hemostasis, or in the retroperitoneum, pulmonary, intracranial, or central nervous system …”

“…However, it is not recommended in critically ill children due to a paucity of studies to support the efficacy of this practice in pediatrics . Critically ill children are also at increased risk of bleeding, which can be amplified with pharmacologic thromboprophylaxis . Thus, it would be ideal to provide pharmacologic thromboprophylaxis only to critically ill children who are at high risk of DVT.…”

“…2 Critically ill children are also at increased risk of bleeding, which can be amplified with pharmacologic thromboprophylaxis. 3,4 Thus, it would be ideal to provide pharmacologic thromboprophylaxis only to critically ill children who are at high risk of DVT. At present, we do not have any validated tests to identify these children.…”

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing

“…Gastrointestinal bleeding is attributed to both decreased prostaglandin synthesis in the gastric mucosa resulting in gastritis and an antiplatelet effect from irreversible COX1 inhibition. Pediatric data describing overall bleeding risks with ASA are limited, but the reported incidence ranges from 2% to 33%, with the highest risks associated with central venous catheter or chest tube sites after cardiac surgery . Pediatric estimates of ASA‐associated gastrointestinal bleeding are even more elusive, because most large studies address bleeding in side‐effect reporting rather than as a primary outcome .…”

“…Pediatric data describing overall bleeding risks with ASA are limited, but the reported incidence ranges from 2% to 33%, with the highest risks associated with central venous catheter or chest tube sites after cardiac surgery. 78,79 Pediatric estimates of ASA-associated gastrointestinal bleeding are even more elusive, because most large studies address bleeding in side-effect reporting rather than as a primary outcome. 80 shown in adults with coronary artery disease (CAD).…”