Pulmonary Embolism in Children

Ramiz, Sarah; Rajpurkar, Madhvi

doi:10.1016/j.pcl.2018.02.002

Cited by 32 publications

(45 citation statements)

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“…Las contraindicaciones son sangrado activo, cirugía general 10 días previos, procedimientos invasivos tres días antes, convulsiones 48 horas antes, hipertensión, riesgo de sangrado en zonas críticas y neurocirugía, isquemia, sangrado, o neurotrauma en los últimos 30 días, inhabilidad de conteo plaquetario >75.000 e inhabilidad de mantener fibrinógeno >100mg/dl. La dosis del factor activador tisular del plasminógeno activado (rt-PA) es 0.1-0.5 mg kg hora, durante 6 a 48 horas con vigilancia del dimero D y fibrinógeno, en caso de hemorragia se administra crioprecipitado 1U/5kg (79,80,82,84,85). Las indicaciones de trombectomía o embolectomía son TEP, cuando la trombólisis está contraindicada y hay tiempo insuficiente para anticoagulación efectiva; sus riesgos son perforación del vaso sanguíneo, migración tromboembólica o hipertensión pulmonar tromboembólica (84).…”

Section: Tabla 3 Ventajas Y Desventajas De Medicamentos Inmunosupresunclassified

Síndrome Nefrótico

et al. 2020

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El síndrome nefrótico (SN) es la manifestación más frecuente de las glomerulopatías primarias no inflamatorias en niños y se caracteriza proteinuria masiva con hipoalbuminemia profunda, con hiperlipidemia y edema secundarios.El SN de etiología primaria entre 15 al 30% de causa de enfermedad renal crónica terminal (ERCT) en Colombia. Dadas las diferencias en el tratamiento instaurado entre pediatras y nefrólogos pediatras, en las dosis y la duración del primer tratamiento, la presencia de efectos adversos asociados a la inmunosupresión, así como los resultados finales, según el centro médico y el recurso humano disponible, se ha realizado esta revisión en un intento de ampliar el conocimiento de la enfermedad, unificando los avances genéticos que han caracterizado el pronóstico así como las nuevas opciones terapéuticas en el manejo de los pacientes difíciles.

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Section: Tabla 3 Ventajas Y Desventajas De Medicamentos Inmunosupresunclassified

Síndrome Nefrótico

et al. 2020

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“…For this reason, clinicians need to be aware of that possibility in paediatric patients with nonspecific symptoms. As distinct from adults we can also observe different mechanism of developing PE such as anomalies of the pulmonary artery and congenital heart disease [6][7]. Rajpurkar et al conducted systematic review of prevalence of PE in younger patients.…”

Section: Risk Factors Paediatric Patientsmentioning

confidence: 99%

“…Authors also mentioned about other significant risk factors such as hormonal supplementation, cancer, immobility or infection. Neshat-Vahid et al demonstrated a relation between V Leiden factor and CVC-related VTE [6][8] [9].…”

Section: Risk Factors Paediatric Patientsmentioning

confidence: 99%

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Pulmonary embolism - assessment of risk factors and emboli locations

Komisarczuk

Kaczor

Kopyto

et al. 2020

J Educ Health Sport

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INTRODUCTION: Pulmonary embolism (PE) is a widespread disorder, which appears as a result of closure or restriction of main pulmonary artery or its branches and is often associated with deep vein thrombosis (DVT).The severity and clinical picture is frequently erratic and what is worrying it is a major cause of hospitalization and mortality in Europe. OBJECTIVE:The main purpose of our study was to demonstrate meaning of emboli location in prognosis, favour risk factors which could be overlooked by clinicians and help to avoid further misdiagnosis. ABBREVIATED DESRCIPTION OF THE STATE OF KNOWLEDGE:We highlighted the importance of defining a genetic profile, personal and family history of VTE, especially in patients with atypical pulmonary symptoms. Moreover, the awareness of possible occurring PE among children, during serious infections or in patients with malignancy is still insufficient. Furthermore, according our analysis clinical symptoms in patients with pulmonary embolism are undoubtedly influenced by the location. The more massive the thrombus appears, the more serious consequences can be expected for the patient. Along with the size of the thrombus, the risk of its complications increases because of haemodynamic changes.SUMMARY:Diagnosing of pulmonary embolism in hemodynamically stable patients is still challenging for clinicians. There were many attempts to find significant and unmistakeable relationship between emboli location in pulmonary vasculature and prognosis.That knowledge could be helpful for clinicians in setting accurate diagnosis, implementing appropriate treatment and avoid possible life-threatening consequences.Risk stratification is crucial to the management and prognosis of patients with acute PE.

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“…Pulmonary embolism (PE) occurs in only about 0.86 in 10 000 children in the general population each year but carries a high risk of mortality (~10%) . When PE is considered in a differential diagnosis, there is considerable decisional conflict because the clinical presentation of PE overlaps with many common pediatric diseases.…”

Section: Introductionmentioning

confidence: 99%

Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

Hennelly

Ellison

Neuman

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: Pulmonary embolism (PE) in children carries a significant morbidity and mortality. We examined previously described factors in 2 cohorts of children tested for PE and identified novel factors. Methods:We combined data from 2 retrospective cohorts. Patients up to age 21 years were included who underwent imaging or D-dimer testing for PE, with positive radiologic testing being the gold standard. Combined predictor variables were examined by univariate analysis and then forward stepwise multivariable logistic regression. Results: The combined data set yielded 1103 patients with 42 unique predictor variables, and 93 PE-positive patients (8.4%), with a median age of 16 years. Univariate analysis retained 17 variables, and multivariable logistic regression found 9 significant variables with increased probability of PE diagnosis: age-adjusted tachycardia, tachypnea, hypoxia, unilateral limb swelling, trauma/surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, cancer, anemia, and leukocytosis. Conclusion: This combined data set of children with suspected PE discovered factors that may contribute to a diagnosis of PE: hypoxia, unilateral limb swelling, trauma/ surgery requiring hospitalization in previous 4 weeks, prior thromboembolism, and cancer, age-adjusted tachycardia, tachypnea, anemia, and leukocytosis. Prospective testing is needed to determine which criteria should be used to initiate diagnostic testing for PE in children. Essentials• Pulmonary embolism (PE) in children carries a significant morbidity and mortality.• We combined data from 2 retrospective cohorts and identified novel predictor variables.• Multivariable logistic regression found 9 significant variables associated with PE diagnosis.• Prospective testing is needed to determine which features predict pediatric PE diagnosis.

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Pulmonary Embolism in Children

Cited by 32 publications

References 83 publications

Síndrome Nefrótico

Síndrome Nefrótico

Pulmonary embolism - assessment of risk factors and emboli locations

Clinical variables that increase the probability of pulmonary embolism diagnosis in symptomatic children

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