ECMO-/ECLS

migrates to recipient’slungs.

Donor antibodies

reacting with

recipient antigen on

granulocytes. Sicker patients tend

to be more

susceptible

Pulmonary failure

VII. Anticoagulation
The American College of Chest Physicians recently published their
updated recommendations on antithrombotic therapy in neonates in children [25].
This reference that provides updated recommendations and guidelines for
management of thrombosis and neonates. One cannot stress enough their
conclusion that there is a paucity of prospective randomized literature evaluating
this condition in children and that the evidence supporting the majority of
recommendations remains weak. Additionally, consideration of consultation with
a hematologist experienced in the management of VTE in children is strongly
supported [25].
Venous thromboembolic (VTE) disease in children is an uncommon
occurrence when compared to the adult population. Overall the incidence has
been found to be about 10 fold lower in the pediatric population [26]. Evaluation
of all pediatric discharges (<18 years of age and excluding routine newborn
hospitalizations) revealed an overall incidence of 0.14% over the period from
1994 to 2009 [27]. The rates were highest in children less than one year of age
and over the time period study increased from 18.1 per 100,000 admissions to
49.6 per 100,000 admissions. The presence of VTE was associated with the use