Skip to Main Content
Skip Nav Destination

A Contributor to Post-operative Venous Thromboembolism You May Not Have Considered :

March 20, 2020

The incidence of venous thromboembolism (VTE) including post-operative VTE is increasing in hospitalized children (references 1 and 4), and reasons for this increase need to be better understood.

The incidence of venous thromboembolism (VTE) including post-operative VTE is increasing in hospitalized children (references 1 and 4), and reasons for this increase need to be better understood. Having a central venous catheter and being septic are just some of the factors that can contribute to VTE formation. Goel et al (10.1542/peds.2019-2351) evaluated the American College of Surgeons’ National Surgical Quality Improvement Project databases to identify other risk factors. The authors found that regardless of age, VTEs were more likely to occur if a patient had received an intra- or post-operative transfusion, with more VTEs occurring when higher weight-based volumes of RBCs were used. This association persisted when other confounders were controlled for, suggesting an independent role of RBC transfusions in the formation of VTEs.

Why might this be? We asked pediatric anesthesiologist Dr. Brian Donahue to share his thoughts in an accompanying commentary (10.1542/peds.2019-3955). Dr. Donahue, as do Goel et al, reminds us of possible mechanisms by which transfused RBCs can increase the risk of clotting. He also identifies some potential limitations affecting this study that may be influencing the results, which potentially reduce the likelihood that RBC transfusion is responsible for the VTEs. For example, patients may have had unidentified genetic variants that could contribute to enhanced clotting or there could be other components in the transfusion that may promote procoagulant. With this study and commentary, the clot thickens when it comes to identifying the association of VTE as a possible complication of RBC transfusions. 

Close Modal

or Create an Account

Close Modal
Close Modal