Prophylaxe der venösen Thromboembolie (VTE)

Encke,; Haas,; Sauerland,; Abholz,; Beckmann,; Bode,; Bootz,; Diener,; Eggeling,; Gerlach,; Gogarten,; Hach-Wunderle,; Heger, Jens; Krauspe,; Kujath,; Kussmann,; Nowak-Göttl,; Pauschert,; Rabe, Klaus F.; Rieß,; Schellong,; Schwerdtfeger,; Senninger,; Stürmer,; Swoboda,; Ulsenheimer,; Aken, V.; Vogt,; Wagner, Verena; Walz,; Waydhas,; Wéber,; Kopp,

doi:10.1024/0301-1526.38.s76.1

Cited by 59 publications

(16 citation statements)

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“…This is also in line with the requirements of national and international guidelines recommending DU as the standard diagnostic procedure for uncomplicated VV [6]. This is a GRADE 1A recommendation in the guidelines of the Society for Vascular Surgery and the American Venous Forum [7].…”

Section: Discussionmentioning

confidence: 53%

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Perioperative quality assessment of varicose vein surgery

Noppeney

Storck

Nüllen³

et al. 2016

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 53%

“…This clearly contradicts the specifications of both current and old guidelines [6][7][8]. This should be discussed with the institutions involved in order to clarify why this was not done in the individual cases.…”

Section: Discussionmentioning

confidence: 91%

Perioperative quality assessment of varicose vein surgery

Noppeney

Storck

Nüllen³

et al. 2016

Langenbecks Arch Surg

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“…Bleeding episodes occur in 1-24% of children treated with heparins and vitamin K antagonist [18][19][20][21]. For further information readers are referred to recently published reviews and guidelines [7,8,22]. It must be kept in mind that guidelines for prevention and treatment of VTE are widely based on expert opinion and experience of tertiary care centres and that virtually no clinical trials have been conducted in neonates and children that define optimal intensity and duration of VTE prevention and treatment.…”

Section: Indications For Anticoagulants and Guidelinesmentioning

confidence: 98%

“…Standard and low molecular weight heparins and vitamin K antagonists are routinely used for the prevention and treatment of VTE in children [7]. Published guidelines on whom to treat, with what agent at what intensity and for how long are based on extrapolation of results of clinical trials in adults and on a small number of case series, observational studies and clinical trials conducted in newborns and older children [7,8]. New anticoagulants with favourable pharmacological properties are currently being investigated in children and have already been used on rare occasions.…”

Section: Introductionmentioning

confidence: 99%

Direct thrombin and factor Xa inhibitors in children: a quest for new anticoagulants for children

Streif

Ageno

2011

Wien Med Wochenschr

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Venous thrombosis and pulmonary embolism rarely occur in children but are associated with significant morbidity and mortality. Venous thromboembolism (VTE) mostly affects children with severe underlying conditions and multiple risk factors. Newborns and adolescents are at the highest risk. Standard and low molecular weight heparins and vitamin K antagonists are routinely used for the prevention and treatment of VTE. The new anticoagulants, both parenteral such as argatroban, bivalirudin and fondaparinux and oral such as dabigatran and rivaroxaban, have favourable pharmacological properties, all are approved for clinical use in adults and are currently being investigated in children. Argatroban is the only new anticoagulant licensed for use in children so far. The role of these new anticoagulants as alternative anticoagulants for children remains to be defined. This review focuses on the characteristics of VTE in children and reviews current knowledge on the use of the new thrombin and factor Xa inhibitors in this population.

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“…VTE sind häufig die unerwartete Über-raschung, die den bis dahin günstigen Heilungsverlauf behindern. Die Strategien zur Prävention und Therapie von VTE bei Kindern beruhen auch heute noch ganz wesentlich auf der Extrapolation von Studienergebnissen bei erwachsenen Patienten [8][9][10][11]. Besonderheiten der kindlichen Hämostase, die den pathophysiologischen Prozess der VTE Entstehung und das Ansprechen auf die Behandlung beeinflussen, lassen diese Strategie der einfachen Ableitung als nicht mehr zeitgemäß erscheinen [12].…”

Section: Introductionunclassified

Perioperative Thromboseprophylaxe bei Kindern

Streif

2009

Wien Med Wochenschr

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Venous thromboembolic events (VTE) occur in children at the time of surgery. Few guidelines about how to assess the risk and provide prophylaxis have been developed and published so far. It is uncertain if any of these guidelines have been adopted into clinical practice. The article discusses the specific differences of the haemostatic system throughout childhood, risk assessment, choice and dosing of antithrombotic agents, difficulties in drug monitoring and side effects of treatment including HIT. Current available recommendations and guidelines are summarized. Current evidence on which to base risk stratification and prevention of VTE for children undergoing surgery consists mainly of cohort studies, case series, case reports and expert opinion. Many suggestions are merely extrapolated from results from clinical trials in adults. Primary healthy children who undergo minor surgery including circumcision, herniotomy and appendectomy do not need antithrombotic prophylaxis. Children with multiple risk factors for VTE including severe underlying conditions and long-term immobilization, children with central venous lines and children with a history of VTE should be considered to receive VTE prophylaxis. Older children (Tanner II+) should be treated following adult guidelines. Standard unfractionated heparin and low molecular heparin are the most frequently recommended antithrombotic drugs. Decision for VTE prophylaxis must widely be based on individual risk assessment by experienced physicians. Newly developed scores and guidelines may provide assistance. Well designed clinical studies in children that provide proper evidence on risk assessment for VTE at the time of surgery and investigate safety and efficacy of antithrombotic prophylaxis/treatment are urgently needed.

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Prophylaxe der venösen Thromboembolie (VTE)

Cited by 59 publications

References 0 publications

Perioperative quality assessment of varicose vein surgery

Perioperative quality assessment of varicose vein surgery

Direct thrombin and factor Xa inhibitors in children: a quest for new anticoagulants for children

Perioperative Thromboseprophylaxe bei Kindern

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