The physiology of pediatric trauma patients leads to lower deep venous thrombosis (DVT) and venous thromboembolism (VTE) event rates than adults.¹ This makes developing guidelines and tracking the effectiveness of chemical VTE prophylaxis (cVTE) challenging.

In this issue of JAMA Surgery, the Midwestern Pediatric Surgical Consortium implemented and prospectively examined a cVTE protocol for high-risk pediatric trauma patients. The authors administered cVTE in 54.5% of qualified patients. They found that VTE occurred in 1.6% and 6.9% of patients, if cVTE was given less than 24 hours and more than 24 hours, respectively, and in 5.3% of patients if cVTE was never given (P = .31), without increasing bleeding complications.² This is the first prospective, multicentered study establishing the risk of VTE in a large population with and without cVTE and demonstrating the safety of cVTE in those patients who received prophylaxis.