Venous thromboembolism (VTE) affects approximately 1 in 200 hospitalized children. The diagnosis of pulmonary embolism (PE), the most severe clinical presentation of VTE, has increased dramatically by ~200% over the past two decades, disproportionately affecting adolescents, and is associated with adverse long-term post-PE sequelae. Nevertheless, the management of pediatric PE remains highly variable. This review focuses on significant advances in pediatric PE with a focus on published studies within the past decade. Using a representative case, we: (1) summarize existing risk prediction tools for acute pediatric PE and a shift in clinical practice in the management of acute PE with the implementation of pediatric PE Response Teams and multidisciplinary decision-making for severe pediatric PE; (2) describe recently completed clinical trials of anticoagulation in children and adolescents and ongoing work to elucidate the appropriate duration of therapy for children and adolescents with PE; (3) review advances in understanding post-PE syndrome and the need for continued refinement of evaluation tools and management approaches. Many unanswered questions remain despite the significant advances in pediatric thrombosis over the past decade.
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Review Article|
July 11, 2025
How I Treat Pediatric Pulmonary Embolism Available to Purchase
Ayesha Zia,
University of Texas Southwestern Medical Center, Dallas, Texas, United States
* Corresponding Author; email: ayesha.zia@utsouthwestern.edu
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Neil A Goldenberg,
Neil A Goldenberg
Johns Hopkins University School of Medicine, St. Petersburg, Florida, United States
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Madhvi Rajpurkar
Madhvi Rajpurkar
United States
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Blood blood.2024026599.
Article history
Submitted:
January 14, 2025
Revision Received:
June 24, 2025
Accepted:
June 25, 2025
Citation
Ayesha Zia, Neil A Goldenberg, Madhvi Rajpurkar; How I Treat Pediatric Pulmonary Embolism. Blood 2025; blood.2024026599. doi: https://doi.org/10.1182/blood.2024026599
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