Introduction

In the acute phase, venous thrombosis of the extremity can be associated with significant swelling, pain and pulmonary embolus associated with respiratory and even life threatening deoxygenation. Chronically it can lead to delayed swelling and pain - especially with limb dependency or exercise). In fact, venous thromboembolism (VTE) in children is associated with significant short- and long term morbidity and mortality when compared to the general population [1].

While the etiology is multifactorial, VTE events correlate to an imbalance of the intrinsic coagulation balance as described by Virchow over a century ago [2]. In the pediatric population, VTE events generally coincide with immobility, recent surgery, inflammation, and/or ongoing critical illness - factors often observed in the inpatient setting [1].