Nursing management of deep vein thrombosis in children: a narrative review of challenges, evidence-based strategies, and systematic pathways.

Background and Objective: Pediatric deep vein thrombosis (DVT) is an increasingly recognized vascular condition with potentially life-threatening consequences. Despite growing clinical awareness, nursing care remains challenging due to the lack of standardized, age-appropriate protocols-often defaulting to adult-oriented approaches. This review aims to synthesize current evidence on the multifactorial etiology, diagnostic challenges, and optimal nursing strategies for pediatric DVT, with a focus on improving early detection, individualized management, and long-term outcomes. Methods: A narrative review was conducted to analyze peer-reviewed studies and clinical guidelines on pediatric DVT published in recent years, focusing on etiology, risk factors, diagnostic difficulties, and nursing interventions. Key Content and Findings: Pediatric DVT arises from a complex interplay of genetic thrombophilias, acquired triggers [e.g., central venous catheters (CVCs), infection], and immune-inflammatory mechanisms. Clinical presentation is highly variable and age-dependent, complicating early diagnosis. Effective nursing strategies include: (I) validated pediatric risk assessment; (II) individualized anticoagulation monitoring; (III) meticulous catheter care; (IV) early mobilization; and (V) nutritional support. Multidisciplinary collaboration, family-centered education, and psychological support are crucial for preventing post-thrombotic syndrome (PTS) and promoting recovery. Conclusions: A tailored, evidence-based nursing framework-grounded in pediatric physiology and centered on family engagement-is essential for optimizing DVT care in children. This review provides a practical foundation for developing standardized, high-quality nursing protocols to enhance safety, efficacy, and long-term outcomes in pediatric DVT management.