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Kids and clots: Expecting the unexpected

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Not just smaller adults

Although many vascular surgeons do not see pediatric patients, it is important to be aware of the problems with diagnosis and the limitations of treatment. The key is a high index of suspicion and education of pediatricians seeing these patients. When vascular surgeons are consulted, they need to work closely with pediatric specialists. The article reemphasizes that kids are not just smaller adults and an understanding of the limitations of diagnosis and treatment are critical.

Dr. Charles Andersen is Chief of Vascular/Endovascular Surgery at Madigan Army Medical Center and an associate medical editor of Vascular Specialist.


 

EXPERT ANALYSIS FROM THE ADVANCED PEDIATRIC EMERGENCY MEDICINE ASSEMBLY

"Neither low-molecular-weight nor unfractionated heparin should ever be used in children with heparin-induced thrombocytopenia," Dr. Callahan said. "In this setting, one of the newer anticoagulants, such as direct thrombin or selective Xa inhibitors, should be used."

About 10% of children with a clot will die, but mortality is highly associated with underlying disease. Children who do survive have a risk of recurrence and an increased risk of death with each recurrence.

Dr. Callahan had no financial disclosures.

msullivan@frontlinemedcom.com

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