Conceptualizing the Future of Thromboprophylaxis for Hospitalized Children.

The practice of thromboprophylaxis in hospitalized children is evolving. Emerging research in pediatric hospital-acquired venous thromboembolism (HA-VTE) prevention continues to grow, yet clinical gaps and barriers persist. In this review, we conceptualize the future of thromboprophylaxis in children with an aim to address current challenges related to the prediction of HA-VTE and assessment of bleeding risk, the safe application of effective pharmacological agents, and implementation of pediatric HA-VTE preventive practices. With the rapid rate of advancement of artificial intelligence, biotechnology, and multi-omics technology, we consider the major role that these technologies can play in the field of thromboprophylaxis. Using a precision medicine framework, we give emphasis towards an individualized risk prediction approach by the application of pediatric risk assessment models as clinical decision support tools and the development of personalized antithrombotic regimens. In addition, we review some current state-of-the-art experimental pharmacological agents that can be developed in the future. Lastly, we discuss the importance of both individual and collaborative stewardship to be able to guide and successfully implement sound practice of thromboprophylaxis in children. Overall, we envision the future of pediatric thromboprophylaxis to support the development of pediatric research related to HA-VTE prevention that fosters safe, evidence-based practice and ultimately, improved outcomes.