# Venous Thromboembolism — GCMD Library living collection

Everything in the library about venous thromboembolism — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 7 cited statements

## Episodes
### Acute Management
- [VTE PPX in High Risk Trauma Patients: 2018 Pediatric Surgery Practice Gap #7](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452) — video · [machine version](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452.md)

### Evidence & Research
- [Quick Literature Updates Ep 21](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050) — video · 4:04 · [machine version](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050.md)

### Case-Based Learning
- [Venous Thromboembolism Prophylaxis In Trauma Patients: Practice Gap...](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349) — video · 10:38 · [machine version](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=0) Transition from previous topic (Ep 1)
- [0:31](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=31) Case presentation and institutional VTE prophylaxis practices (Ep 1)
- [4:18](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=258) Risk stratification and management algorithm (Ep 1)
- [8:28](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=508) Practical implementation and summary (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452?t=0) VTE prophylaxis in low bleeding risk trauma patients (Ep 2)
- [0:34](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452?t=34) VTE prophylaxis in high bleeding risk trauma patients (Ep 2)
- [0:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=16) VTE Prophylaxis in Pediatric Trauma (Ep 3)
- [1:44](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=104) Fertility Preservation in Childhood Cancer (Ep 3)
- [2:47](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=167) Nephron-Sparing Surgery for Wilms Tumor (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Pediatric surgeons historically did not routinely address VTE prophylaxis, with general teaching some time ago being that kids just didn't get this problem. — Todd Ponsky (opinion) [Ep 1 · 0:31](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=31)
- Recognition of pediatric VTE has increased significantly over the last 10-20 years, possibly to the point of overuse (e.g., SCDs for 30-minute inguinal hernia repairs). — Todd Ponsky (opinion) [Ep 1 · 0:31](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=31)
- The Midwest Pediatric Surgery Consortium is conducting a multi-center study (at 11 centers) of a standardized VTE prophylaxis protocol involving chemoprophylaxis with antithrombin 1A, compression devices, and daily ultrasound evaluation. (clinical) [Ep 1 · 2:55](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=175)
- The number of DVT complications in pediatric patients is very small but catastrophic when they occur. (epidemiological) [Ep 1 · 2:55](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=175)
- The vast majority of pediatric DVTs occur around central lines, and all central lines have a fibrin sheath if examined closely. (clinical) [Ep 1 · 3:56](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=236)
- SCDs should be activated prior to induction of anesthesia in the operating room. (guideline) [Ep 1 · 8:30](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=510)
- The Landish article (David Gourlay's article) is probably the best protocol available for pediatric VTE prophylaxis and forms the basis for the MWPSC multi-center study. (opinion) [Ep 1 · 10:00](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=600)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Pediatric trauma patients are at high risk for developing venous thromboembolism (VTE). — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:02](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=62)
- The Wita et al. cohort study was conducted from 2019 to 2022 in eight pediatric trauma centers and included patients younger than 18 years old. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:09](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=69)
- Among 460 high-risk pediatric trauma patients, more than half received chemical VTE prophylaxis. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:18](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=78)
- Delaying blood thinners beyond 24 hours of hospital arrival increases the risk of blood clots in pediatric trauma patients. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=85)
- VTE prophylaxis is safe and effective for pediatric trauma patients and needs to be started within 24 hours of admission. — Lizzie Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:32](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=92)
- Gillielli et al. reviewed 104 abstracts and 34 full text articles, ultimately including 12 studies in their systematic review of female fertility cryopreservation in childhood cancer. — Alex Halpern summarizing a resource [Ep 3 · 2:04](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=124)
- Ovarian tissue cryopreservation was performed in 501 pediatric cancer patients, with 5.9% undergoing ovarian tissue transplantation. — Alex Halpern summarizing a resource [Ep 3 · 2:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=136)
- After ovarian tissue transplantation, 33% of pediatric cancer patients were able to become pregnant. — Alex Halpern summarizing a resource [Ep 3 · 2:27](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=147)
- Ovarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further. — Alex Halpern summarizing a resource [Ep 3 · 2:33](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=153)
- The Lee et al. systematic review and meta-analysis from Chongqing, China evaluated efficacy and long-term renal function after nephron-sparing surgery in patients with unilateral Wilms tumor. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:09](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=189)
- The meta-analysis gathered 26 studies on nephron-sparing surgery for unilateral Wilms tumor. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:23](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=203)
- Nephron-sparing surgery increased glomerular filtration rate after surgery for unilateral Wilms tumor. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=205)
- Nephron-sparing surgery showed no significant differences in overall survival, recurrences, hypertension, or renal dysfunction compared to radical nephrectomy for unilateral Wilms tumor. — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-21-11050?t=205)
- The theoretically correct answer for the case is screening ultrasound on ICU day 7, because pharmacologic prophylaxis is contraindicated due to significant head bleed. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- A 2017 seminars summary by Dr. Perry (current chair of the Abstinence trauma Committee) provides a comprehensive review of pediatric VTE prophylaxis in trauma. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- VTE incidence in pediatric trauma patients is estimated between 0.16% and 1%, probably on the order of 1% or less in general. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- In adult trauma patients, VTE incidence is about 3-5%. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- In adult neuro trauma patients, VTE incidence is significantly higher at 10-15%. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- Pediatric VTE risk factors include central catheters, inflammatory bowel disease (chronic inflammatory states), blood transfusion, and obesity. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- According to the Landish schema, high-risk patients are defined as those greater than 12 years with one or more risk factors, or less than 12 years with more than 4 risk factors. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- For high-risk patients without bleeding concerns, treatment is low molecular weight heparin plus SCDs until ambulatory. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- For high-risk patients who are not candidates for pharmacologic prophylaxis, treatment is SCDs until ambulatory plus screening ultrasound on day 7. — Todd Ponsky summarizing the discussion [Ep 1 · 4:37](https://origin-library.globalcastmd.com/watch/venous-thromboembolism-prophylaxis-in-trauma-patients-practice-gap-349?t=277)
- For low bleeding risk trauma patients, the recommendation is to use SCDs and low molecular weight heparin for VTE prophylaxis. — Alex summarizing the discussion [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452?t=0)
- For high bleeding risk trauma patients, the recommendation is to use SCDs until the patient is ambulatory, followed by a screening ultrasound on ICU day seven. — Alex summarizing the discussion [Ep 2 · 0:34](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452?t=34)
- In high bleeding risk trauma patients, low molecular weight heparin is withheld from the VTE prophylaxis regimen. — Alex summarizing the discussion [Ep 2 · 0:34](https://origin-library.globalcastmd.com/watch/vte-ppx-in-high-risk-trauma-patients-2018-pediatric-surgery-practice-gap-7-1452?t=34)

## Changelog
- Sep 25: 3 items added automatically

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