Thromboprophylaxis in critically ill children in Spain and Portugal

Introduction: Although critically ill children may be at risk from developing deep venous thrombosis (DVT), data on its incidence and effectiveness of thromboprophylaxis are lacking. Objective: To describe the use of thromboprophylaxis in critically ill children in Spain and Portugal, and to compare the results with international data. Material and methods: Secondary analysis of the multinational study PROTRACT, carried out in 59 PICUs from 7 developed countries (4 from Portugal and 6 in Spain). Data were collected from patients less than 18 years old, who did not receive therapeutic thromboprophylaxis. Results: A total of 308 patients in Spanish and Portuguese (Iberian) PICUS were compared with 2176 admitted to international PICUs. Risk factors such as femoral vein (P = .01), jugular vein central catheter (P < .001), cancer (P = .03), and sepsis (P < .001) were more frequent in Iberian PICUs. The percentage of patients with pharmacological thromboprophylaxis was similar in both groups (15.3% vs. 12.0%). Low molecular weight heparin was used more frequently in Iberian patients (P < .001). In treated children, prior history of thrombosis (P = .02), femoral vein catheter (P < .001), cancer (P = .02) and cranial trauma or craniectomy (P = .006), were more frequent in Iberian PICUs. Mechanical thromboprophylaxis was used in only 6.8% of candidates in Iberian PICUs, compared with 23.8% in the international PICUs (P < .001). Documento descargado de http://www.analesdepediatria.org el 13/04/2017. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. Thromboprophylaxis in critically ill children 145 Conclusions: Despite the presence of risk factors for DVT in many patients, thromboprophy-laxis is rarely prescribed, with low molecular weight heparin being the most used drug. Passive thromboprophylaxis use is anecdotal. There should be a consensus on guidelines of thrombo-prophylaxis in critically ill children. Los factores de riesgo: catéter en vena femoral (p = 0,01), yugular (p < 0,001), cáncer (p = 0,03) y sepsis (p < 0,001) fueron más frecuentes en las UCIP ibéricas. El porcentaje de pacientes con tromboprofilaxis farmacológica fue similar en ambos grupos (15,3% vs. 12,0%). La heparina de bajo peso molecular se utilizó con mayor frecuencia en las UCIP ibéricas (p < 0,001). En los pacientes con profilaxis, la historia de trombosis (p = 0,02), catéter venoso femoral (p < 0,001), cáncer (p = 0,02) y trauma craneal o craneotomía (p = 0,006) fueron más frecuentes en las UCIP ibéricas. En …