Thromboembolic Complications During Infancy and Childhood
Maureen Andrew, Paul T. Monagle and LuAnn Brooker;
Thromboembolic Complications During Infancy and Childhood
B.C. Decker, Inc. Hamilton, London, 2000.
Over the past two decades, the frequency, severity and clinical impact of clots in children have increased dramatically. This trend has been fueled by new aggressive therapies for serious childhood illness and the extensive use of central venous catheters. Physicians caring for children have long needed a thorough review of pediatric thrombotic disease. Thromboembolic Complications During Infancy and Childhood fills that need.
The book is well organized. The chapters are arranged in a logical sequence. The stage is set with a discussion of the unique aspects of pediatric hemostasis followed by a comprehensive review of hypercoagulable conditions. Several subsequent chapters discuss major classes of thromboembolic problems such as arterial thromboses, venous thromboses and pulmonary embolism. Epidemiologic, diagnostic and therapeutic issues are covered within each chapter. There is a chapter on thromboses in the central nervous system. Another focuses on clots in specific organs such as the heart or those associated with specific diseases such as sickle cell anemia. The next series of chapters cover current therapeutic modalities including unfractionated and low-molecular weight heparin, oral anticoagulation, thrombolytic therapy, anti-platelet agents and newer anticoagulants. The final chapter contains a discussion of the laboratory workup for patients with thromboembolic disease. A CD in pdf format is included with the text.
Throughout the text, the authors emphasize the principles of evidenced-based medicine for establishing recommendations. The strength of the data is determined with evidence-based medicine criteria. A consistent problem is the relative scarcity of controlled clinical trials in pediatric patients with thrombotic disorders. The authors point out in the introduction that none of the 1998 American College of Chest Physicians recommendations regarding pediatric thromboembolism were based on Grade A evidence and that >90% were based on observational studies. Hence, specific recommendations in the text are often derived from these observational studies or are extrapolated from adult data. The source of the recommendation is generally stated. The authors take the time to note the many areas for ripe for future research.
While the text contains a comprehensive review of the available literature, it is quite readable. There are extensive references. The tables and graphs are helpful and well placed. There is a continuous comparison of adult and pediatric data. Most importantly, the text covers the range of the difficult clinical problems facing clinicians caring for children at risk for or suffering from thrombotic disease. Therefore, this textbook should be readily at hand for the many pediatric specialists caring for these patients.
Reviewed by:
Eric J. Werner, MD
Childrens Hospital of the Kings Daughters
Norfolk, VA
 Copyright 1995-2010 - Carden Jennings Publishing Co., Ltd. All rights reserved. The material available at this site is for educational purposes only and is NOT intended for any diagnostic, clinically related, or other purpose. Carden Jennings Publishing Co., Ltd., assumes no responsibility for any use or misuse of this material and makes no warranty or representation of any kind with respect to the material available at this site.
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