Johns Hopkins All Children's Maternal Fetal and Neonatal Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL.
Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL.
Neoreviews. 2023 Jun 1;24(6):e356-e369. doi: 10.1542/neo.24-6-e356.
Neonates, particularly critically ill and premature infants, have one of the highest risks of thromboembolic complications, particularly venous thromboembolism (VTE), in the pediatric population. Recent data suggest that the incidence of VTE has significantly increased in neonates over the last few decades. Critically ill and premature infants exhibit multiple risk factors that place them at a high risk for thromboembolic events including developmental hemostasis, propensity to infections, and frequent need for central venous access. The clinical presentation, diagnostic modalities, and treatment strategies for thromboembolic complications in neonates vary based on several factors, including the etiology of the thromboembolic event, the anatomic site affected, and the patient's underlying comorbidities. Although guidelines for management are available, they are mostly based on consensus recommendations and on extrapolation from adult data due to a lack of high-quality data in the neonatal population. Current guidelines recommend anticoagulation for specific scenarios. More studies are necessary to elucidate optimal management strategies for newborns with thromboembolic complications.
新生儿，尤其是重症和早产儿，在儿科人群中具有最高的血栓栓塞并发症风险之一，特别是静脉血栓栓塞症（VTE）。最近的数据表明，在过去几十年中，新生儿的 VTE 发病率显著增加。重症和早产儿表现出多种风险因素，使他们处于血栓栓塞事件的高风险中，包括发育性止血、易感染和经常需要中心静脉通路。新生儿血栓栓塞并发症的临床表现、诊断方式和治疗策略因多种因素而异，包括血栓栓塞事件的病因、受影响的解剖部位以及患者的潜在合并症。尽管有管理指南，但它们主要基于共识建议和从成人数据外推，因为新生儿人群中缺乏高质量的数据。目前的指南建议在特定情况下进行抗凝治疗。需要更多的研究来阐明新生儿血栓栓塞并发症的最佳管理策略。
