• Philip C Jackson and Judith M Morgan.
• Anaesthetic Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, UK.
• Paediatr Anaesth. 2008 Jun 1;18(6):478-87.

BackgroundVenous thromboembolic (VTE) events can occur in children at the time of surgery where a patient has associated prothrombotic risk factors. There is currently little advice available to anesthetists on how to assess the risks and provide prophylaxis.Aim/ObjectiveTo increase awareness of thrombosis in the perioperative pediatric patient, and to give some guidance when considering prophylaxis in this group.Method/ResultsA guideline outlining risk factors for venous thromboembolism in patients presenting for surgery was written as a flowchart. Recommendations for low risk patients was early mobilization and good hydration; for moderate risk patients having major general surgery to include physical prophylaxis where size permits, i.e. elastic stockings and compression devices; for high-risk patients undergoing major orthopaedic or general surgery to also receive prophylactic low molecular weight heparin enoxaparin 0.5 mg x kg(-1) b.d.ConclusionChildren with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.

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