The incidence of pediatric venous thromboembolism (VTE) has been increasing significantly over the past decade in part as a result of increased recognition of this serious disorder but more so because of the increased use of central venous catheters and other technological advancements involved in the care of ill children. Management of pediatric VTE is a complex undertaking, considering that the vast majority of children who develop this complication have serious underlying medical disorders. Although the incidence is rising, in comparison with adults, this remains a relatively rare disorder, and as such, large-scale clinical trials have not been completed, rendering management decisions to be based on extrapolation from adult data and the experience of the treating physician. Clearly, both are fraught with problems. Thus, day-to-day management remains more art than science until such time that the results from clinical trials (many of which are under way) become available. This edition of “How I Treat” describes the author’s experience in managing 3 common scenarios that one may encounter in pediatric thrombosis and suggests a logical approach to such situations. Furthermore, the author provides 3 algorithms to help guide management decisions.

过去十年中，小儿静脉血栓栓塞症（VTE）的发病率显着增加，部分原因是对这种严重疾病认识的增强，但更多地是由于中央静脉导管的使用增加以及与护理有关的其他技术进步生病的孩子。考虑到绝大多数发生这种并发症的儿童都患有严重的基础医学疾病，因此小儿VTE的管理是一项复杂的工作。尽管发病率正在上升，但与成人相比，这仍然是一种相对罕见的疾病，因此，尚未完成大规模的临床试验，因此管理决策要基于成人数据和主治医生的经验进行推断。显然，两者都充满了问题。因此，直到获得临床试验的结果（其中许多正在进行中）之前，日常管理仍比科学更具艺术性。此版本的“我如何治疗”描述了作者在处理3种常见情况下可能遇到的小儿血栓形成的经验，并提出了处理此类情况的合乎逻辑的方法。此外，作者提供了3种算法来帮助指导管理决策。