Publications by authors named "C van Ommen"
Introduction: The pediatric direct oral anticoagulation (DOAC) trials provide an opportunity to evaluate and characterize challenges in their design and execution to inform future antithrombotic trials.
Objective: To perform a systematic review of pediatric DOAC trials for the treatment of venous thromboembolism to critically appraise their methodology and understand the feasibility and challenges.
Methods: Systematic search of MEDLINE, EMBASE, the Cochrane Library and ClinicalTrials.
Objectives: To determine if a priori standardization of outcome hemostatic definitions alone was adequate to enable useful comparison between two cohorts of pediatric extracorporeal membrane oxygenation (ECMO) patients, managed according to local practice and protocol.
Design: Comparison of two separate prospective cohort studies performed at different centers with standardized outcome definitions agreed upon a priori.
Setting: General and cardiac PICUs at the Royal Children's Hospital (RCH) in Melbourne, Australia, and the Sophia Children's Hospital (SCH) in Rotterdam, The Netherlands.
Adolescent venous thromboembolism (VTE) has unique challenges in management, complications, and compliance to anticoagulants. Direct oral anticoagulants (DOACs) have been approved for pediatric VTE management, with an increasing use especially in adolescents. Primary objective is to evaluate the safety and efficacy of DOAC therapy in adolescent VTE.
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- Bleeding and thrombotic complications are prevalent in ECMO patients, impacting mortality and morbidity; this study compares complication rates before and after a change in anticoagulation monitoring protocol.
- A retrospective cohort study involved 250 adult ECMO patients, analyzing demographics, ECMO data, and coagulation tests to evaluate the effectiveness of the aPTT guided and multimodal protocols.
- Results showed that complication rates were similar between the two protocols, and surgical interventions significantly increased the risk of both bleeding and thrombotic issues.
The incidence of pediatric pulmonary embolism (PE) has increased by 200 % in the last decade, but at a single center, it is still infrequent. Given the unique epidemiologic features of pediatric PE, diagnosis is often delayed, and the management is empiric, based on individual physician experience or preference. Thus, there is a strong need for center-specific uniform management of pediatric PE patients.
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