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Analysis of antithrombotic therapy and pharmaceutical care in a child with severe pneumonia complicated with intraventricular thrombosis and pulmonary embolism with high renal excretion rate

Published on Aug. 30, 2024Total Views: 1223 times Total Downloads: 329 times Download Mobile

Author: WANG Liyuan 1, 2 WANG Facai 2 LI Ping 1

Affiliation: 1. Department of Clinical Pharmacy, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China 2. Department of Pharmacy, Lu'an Hospital Affiliated to Anhui Medical University (Lu'an People's Hospital), Lu'an 237005, Anhui Province, China

Keywords: Severe pneumonia Pulmonary embolism High renal excretion rate Antithrombotic therapy Pharmaceutical care

DOI: 10.12173/j.issn.1005-0698.202406014

Reference: WANG Liyuan, WANG Facai, LI Ping.Analysis of antithrombotic therapy and pharmaceutical care in a child with severe pneumonia complicated with intraventricular thrombosis and pulmonary embolism with high renal excretion rate[J].Yaowu Liuxingbingxue Zazhi,2024, 33(8):938-943.DOI: 10.12173/j.issn.1005-0698.202406014.[Article in Chinese]

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Abstract

Clinical pharmacists participated in the antithrombotic diagnosis and treatment of a child with severe pneumonia complicated with intraventricular thrombosis, pulmonary embolism and high renal excretion rate. The child was admitted to the hospital due to "severe pneumonia". Based on the initial coagulation routine indicators, it was considered that the coagulation dysfunction was caused by severe pneumonia. Later, it progressed to right ventricular thrombus and multiple embolisms in both pulmonary arteries. The clinical pharmacist evaluated the risk of thrombus and bleeding by considering the child's age, weight, dynamic changes in disseminated intravascular coagulation and platelet count indicators, as well as liver and kidney function changes. They assisted the clinician in developing an individualized antithrombotic treatment plan. During hospitalization, the child's D-dimer level increased progressively, which was considered to be related to the child's high renal excretion rate. The clinical pharmacist promptly suggested adjusting the frequency and dosage of the antithrombotic medication. The clinician adopted the suggestion, and the child's thrombus masses reduced and dissipated. The child recovered well during hospitalization and was discharged smoothly, follow-up showed no recurrence of thrombus. Clinical pharmacists assisted physicians in developing individualized antithrombotic regimens for children through full pharmacological monitoring, which improved the prognosis of the children, ensured the effectiveness and safety of antithrombotic medication use, and could also provide a reference for antithrombotic therapy for similar children.

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References

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