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Background <p>Pulmonary thromboembolism is rare in children, but can be life-threatening. Timely diagnosis and treatment of pulmonary thromboembolism are crucial for reducing mortality associated with pulmonary thromboembolism in children. While guidelines for pulmonary thromboembolism in adults are available, guidelines for standardized diagnosis and management of pulmonary thromboembolism in children are not. This expert consensus aims to provide recommendations for the management of pulmonary thromboembolism in children based on the current best available evidence.</p> Data sources <p>Following the World Health Organization Handbook for Guideline Development, the expert panel consisted of 30 members from different clinical areas. The panel identified clinical questions through systematic reviews and expert discussions, systematically reviewed evidence on pulmonary thromboembolism in children, and evaluated the quality of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Using the GRADE Evidence to Decision Framework, the panel made recommendations, considering the effects of interventions, resource use, values and preferences, equity, acceptability, and feasibility.</p> Results <p>The epidemiology, classification, and pathophysiology characteristics are summarized. The expert panel developed 33 recommendations addressing 20 questions related to diagnosis steps, treatment approaches such as anticoagulant therapy, thrombolysis therapy, catheter-based interventional therapy, surgical embolectomy, multidisciplinary team, and treatment of patients with comorbidities, prognosis, education, as well as follow-up. Among these, 18 are weak recommendations based on very low quality evidence, and 15 are good practice statements.</p> Conclusions <p>The expert panel provided recommendations for pulmonary thromboembolism in children based on available evidence, which was generally low in quality and volume. The panel urges further research on early identification and diagnosis strategies, preventive and therapeutic regimens, and long-term management for pulmonary thromboembolism.</p> Graphical abstract <p></p>

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Management of pulmonary thromboembolism in children: an evidence-based expert consensus

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月20日

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  • Li-Nan Zeng,
  • Ying-Xue Zou,
  • Hai-Lin Zhang,
  • Li-Na Chen,
  • De-Hui Chen,
  • Xin-Xin Chen,
  • Xing Chen,
  • Zhi-Min Chen,
  • Xiao-Yan Dong,
  • Liang Huang,
  • Yi Ji,
  • Yong-Mei Jiang,
  • Zhi-Ping Li,
  • En-Mei Liu,
  • Shu-Hua Luo,
  • Xiao-Feng Ni,
  • Guang-Min Nong,
  • Yun Peng,
  • Su-Yun Qian,
  • Tian-You Wang,
  • Xin-Yu Yuan,
  • Hao Zhang,
  • Hong Zhang,
  • Xiao-Bo Zhang,
  • De-Yu Zhao,
  • Shun-Ying Zhao,
  • Xiu-Fang Zhao,
  • Kai-Yu Zhou,
  • Quan Lu,
  • Ling-Li Zhang,
  • Han-Min Liu

摘要

Background

Pulmonary thromboembolism is rare in children, but can be life-threatening. Timely diagnosis and treatment of pulmonary thromboembolism are crucial for reducing mortality associated with pulmonary thromboembolism in children. While guidelines for pulmonary thromboembolism in adults are available, guidelines for standardized diagnosis and management of pulmonary thromboembolism in children are not. This expert consensus aims to provide recommendations for the management of pulmonary thromboembolism in children based on the current best available evidence.

Data sources

Following the World Health Organization Handbook for Guideline Development, the expert panel consisted of 30 members from different clinical areas. The panel identified clinical questions through systematic reviews and expert discussions, systematically reviewed evidence on pulmonary thromboembolism in children, and evaluated the quality of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Using the GRADE Evidence to Decision Framework, the panel made recommendations, considering the effects of interventions, resource use, values and preferences, equity, acceptability, and feasibility.

Results

The epidemiology, classification, and pathophysiology characteristics are summarized. The expert panel developed 33 recommendations addressing 20 questions related to diagnosis steps, treatment approaches such as anticoagulant therapy, thrombolysis therapy, catheter-based interventional therapy, surgical embolectomy, multidisciplinary team, and treatment of patients with comorbidities, prognosis, education, as well as follow-up. Among these, 18 are weak recommendations based on very low quality evidence, and 15 are good practice statements.

Conclusions

The expert panel provided recommendations for pulmonary thromboembolism in children based on available evidence, which was generally low in quality and volume. The panel urges further research on early identification and diagnosis strategies, preventive and therapeutic regimens, and long-term management for pulmonary thromboembolism.

Graphical abstract