Epidemiology of Lower Extremity Deep Venous Thrombosis in Critically Ill Adolescents

Faustino, E. Vincent S.; Shabanova, Veronika; Pinto, Matthew; Li, Simon; Trakas, Erin; Miksa, Michael; Gertz, Shira J.; Polikoff, Lee; Napolitano, Massimo; Brudnicki, Adele; Tala, Joana; Silva, Cícero Inácio da; Investigators, THrombosis Epidemiology in Ill Adolescents Study

doi:10.1016/j.jpeds.2018.05.006

Cited by 20 publications

(12 citation statements)

References 49 publications

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“…Risk factors for thromboembolism can be divided into two groups, genetic and acquired. Genetic risk factors include loss and gain of coagulation function disorders [ 16 ]. According to studies, people having factor V Leiden or prothrombin 21210 mutation have the higher risk of thromboembolism than those without them [ 17 ].…”

Section: Reviewmentioning

confidence: 99%

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Ejaz

Ahmed

Tasleem

et al. 2018

Cureus

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Thromboembolism is a major complication in hospitalized patients. Intensive care unit (ICU) patients have a greater risk of thrombotic events due to additional risk factors such as immobilization, mechanical ventilation, and central catheters. The diagnosis and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in critically ill patients are challenging and these conditions are associated with high mortality. Medical thromboprophylaxis with low molecular weight heparin (LMWH) as well as unfractionated heparin (UFH) has been shown to reduce the incidence of thromboembolic events in such patients. For patients with high risk of bleeding, mechanical thromboprophylaxis can be used. Literature database was conducted on Medline for articles published up to 2018 using particular search terms such as thromboprophylaxis and venous thromboembolism in ICU patients. The following review summarizes the existing data regarding thromboprophylaxis in ICU patients with special consideration to the use of mechanical prophylaxis and pharmacologic prophylaxis using heparin products.

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Section: Reviewmentioning

confidence: 99%

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Ejaz

Ahmed

Tasleem

et al. 2018

Cureus

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“…The plasma levels of the proteins were log‐transformed because of their nonnormal distribution. Logistic regression was used for all comparisons with DVT as dependent variable and level of the protein as independent variable adjusted for the presence of femoral central venous catheter (CVC) and severity of illness, both of which were shown to be associated with DVT in the THEIA study . For proteins analyzed using SOMAscan, only those that were statistically significant in the bivariate analyses were advanced for additional adjustment.…”

Section: Methodsmentioning

confidence: 99%

“…The THEIA study was previously reported in detail . In brief, it was a multicenter, prospective, cohort study of adolescents receiving cardiopulmonary support.…”

Section: Methodsmentioning

confidence: 99%

“…The primary outcome measure of the THEIA and this exploratory study was the development of DVT in the lower extremity, which is the most common site of DVT in adolescents. 15 Ultrasonography of the deep veins of the bilateral lower extremities was performed (1) upon enrollment, (2) after cardiopulmonary support was discontinued, and (3a) discharge from the ICU or at (3b) 28 days after start of cardiopulmonary support, whichever occurred first. A committee of two pediatric radiologists and a vascular surgeon, all with extensive clinical expertise on the diagnosis of DVT with ultrasound, centrally and blindly adjudicated the studies.…”

Section: Outcome Measurementioning

confidence: 99%

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

Tala

Polikoff

Pinto

et al. 2020

Pediatric Blood & Cancer

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Background There are no tests to identify critically ill children at high risk of deep venous thrombosis (DVT). In this exploratory study, we aimed to identify proteins that are associated with incident DVT in critically ill adolescents. Procedure Plasma samples were obtained from critically ill adolescents within 24 hours after initiation of cardiopulmonary support. The adolescents were followed with ultrasound to detect the development of DVT of the lower extremity and clinically for bleeding. Thrombin‐antithrombin complex and prothrombin fragment 1+2 were measured using immunosorbent assays, whereas procoagulation and anticoagulation factors were measured using multiplex assays. Plasma samples were also analyzed using SOMAscan, an aptamer‐based capture assay. The associations between DVT and the log‐transformed level of the proteins were assessed using logistic regression adjusting for the presence of femoral venous catheter and severity of illness. Associations were expressed as odds ratio (OR) for every log‐fold increase in level of the protein with 95% confidence interval (CI). Results Plasma from 59 critically ill adolescents, of whom 9 developed incident DVT, was analyzed. The median age of the adolescents was 15.1 years (interquartile range, 14.0‐16.7 years). Higher levels of thrombin‐antithrombin complex (OR: 31.54; 95% CI: 2.09‐475.92) and lower levels of factor XIII (OR: 0.03; 95% CI: 0.002‐0.44) were associated with DVT. CD36, MIC‐1, and EpoR were marginally associated with DVT. Only factor XIII was associated with clinically relevant bleeding (OR: 0.27; 95% CI: 0.08‐0.97). Conclusions We identified candidate protein biomarkers for incident DVT. We plan to validate our findings in adequately powered studies.

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“…[5][6][7][8][9] In fact, the correlation between malignant cancer and thromboembolism was established for more than 150 years. Later, it was reported that the risk of hospitalized patients with cancer to develop venous thromboembolism was 4.1 times higher than that of the non-cancer patients, [10][11][12][13][14][15][16] and conversely venous thromboembolism was one of the leading causes of the deaths of patients with some types of malignant cancer. 17 In addition to venous embolism, arterial embolism was correlated with specific malignant cancer 18,19 and cancer therapies.…”

Section: Introductionmentioning

confidence: 99%

<p>Modifying ICCA with Trp-Phe-Phe to Enhance in vivo Activity and Form Nano-Medicine</p>

Zhang

Wang

et al. 2020

IJN

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Background: 1-(4-isopropylphenyl)-β-carboline-3-carboxylic acid (ICCA) was modified by Trp-Phe-Phe to form 1-(4-isopropylphenyl)-β-carboline-3-carbonyl-Trp-Phe-Phe (ICCA-WFF). Purpose: The object of preparing ICCA-WFF was to enhance the in vivo efficacy of ICCA, to explore the possible targeting action, and to visualize the nano-feature. Methods: The advantages of ICCA-WFF over ICCA were demonstrated by a series of in vivo assays, such as anti-tumor assay, anti-arterial thrombosis assay, anti-venous thrombosis assay, P-selectin expression assay, and GPIIb/IIIa expression assay. The nano-features of ICCA-WFF were visualized by TEM, SEM and AFM images. The thrombus targeting and tumor-targeting actions were evidenced by FT-MS spectrum analysis. Results: The minimal effective dose of ICCA-WFF slowing tumor growth and inhibiting thrombosis was 10-fold lower than that of ICCA. ICCA-WFF, but not ICCA, formed nano-particles capable of safe delivery in blood circulation. In vivo ICCA-WFF, but not ICCA, can target thrombus and tumor. In thrombus and tumor, ICCA-WFF released Trp-Phe-Phe and/or ICCA. Conclusion: Modifying ICCA with Trp-Phe-Phe successfully enhanced the anti-tumor activity, improved the anti-thrombotic action, formed nano-particles, targeted tumor tissue and thrombus, and provided an oligopeptide modification strategy for heterocyclic compounds.

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Epidemiology of Lower Extremity Deep Venous Thrombosis in Critically Ill Adolescents

Cited by 20 publications

References 49 publications

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

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

<p>Modifying ICCA with Trp-Phe-Phe to Enhance in vivo Activity and Form Nano-Medicine</p>

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