Pulmonary Embolism in Children
Mohammad Ashkan Moslehi. MD,Interventional Pulmonologist & Intensivist, Director of Pediatrics Interventional Pulmonology Division, Shiraz University of Medical Sciences, Shiraz, Iran
Pulmonary embolism (PE) in children is a rare condition with potential for high mortality.
Material and Methods: This is a retrospective review.
As expected, PE is a very uncommon diagnosis in children. Before 1962, there were fewer than 50 cases of PE reported in the medical literature. however, pulmonary embolic phenomenon occurs with a greater frequency than is generally recognized. Rates of pediatric PE in hospitalized patients increased 184% from 2001 to 2014. Factors that have been shown to be predictive of PE in adults, such as age older than 65 years, tachycardia, a history of immobilization or surgery, previous PE, deep vein thrombosis (DVT), hemoptysis, and malignancy, may not be applicable in the pediatric population.
Treatment includes thrombolysis or thrombectomy, and pharmacologic anticoagulation. Ongoing clinical trials are evaluating the use of direct oral anticoagulants in children. Mortality as a result of PE in children has decreased over time and is now comparable to that from VTE.
It seems that the rate of PEs in hospitalized pediatric patients is increasing out of proportion to the rate of VTE increase. Patients with PEs have a higher mortality rate, although mortality has decreased over the last 10 years.
Pediatrics; Pulmonary embolism; Anticoagulation; deep vein thrombosis