Yin Wang ^1,2 Qinan Yin ^1,2 Liao Jianting ^1,2 Na Wang ³ Li Li ⁴ Siyan Li ⁵ Qingxia Zhang ⁶ Feifei Yu ⁷ Jianchun Luo ⁸ Hongmei Wang ⁹ Die Hu ¹⁰ Wenyi Li ¹¹ Biao Li ¹² Jingjing Chen ¹³ Limei Dong ¹⁴ Min Luo ¹⁵ Yu Yan ¹⁵ Lie Dong ¹⁰ Zheng Ding ¹⁶ Xi Wei ¹⁷ Jiadan Yang ⁹ Sheng-Lan Tan ¹⁸ Li Lian ¹⁹ Xi Zheng ^1,2 Liuyun Wu ^1,2 Yong Yang ^1,2 Linan Zeng ¹³ Jinqi Li ^1,2* Lizhu Han ^1,2* Bian Yuan ^1,2*

• ¹ Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
• ² Sichuan Province Key Laboratory of Personalized Drug Therapy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
• ³ Department of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Yuzhong District, Chongqing 400010, China
• ⁴ Department of Pharmacy, Guizhou Provincial People Hospital, No. 83 Zhongshan East Road, Nanming District, Guiyang 550002, China
• ⁵ School of Pharmaceutical Sciences, Capital Medical University, No. 10, Xitoutiao, You'anmenwai, Fengtai District, Beijing 100069, China
• ⁶ Department of Pharmacy, Xuanwu Hospital, Capital Medical University，45 Changchun Street, Xicheng District, Beijing 100053, China
• ⁷ Children’s Hospital of Chongqing Medical University，National Clinical Research Center for Child Health and Disorders，Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
• ⁸ The Affiliated Hospital, Southwest Medical University. 25 Taiping Street, Jiangyang District, Luzhou 646000, China
• ⁹ Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road Yuzhong District, Chongqing 400016, China
• ¹⁰ Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, The Third People‘s Hospital of Chengdu,No. 82 Qinglong Street, Qingyang District, Chengdu 610031, China
• ¹¹ Qianwei County People's Hospital, No. 1179 Jinhua Avenue, Yujin Town, Qianwei County, Leshan 614400, China
• ¹² The People's Hospital of Leshan;238 Baita Street, Shizhong District, Leshan 614000, China
• ¹³ Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University，No.20, section 3, Renmin South Road, Chengdu, China
• ¹⁴ Department of Pharmacy, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
• ¹⁵ Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
• ¹⁶ Department of Pharmacy, Fuwai hospital, Chinese Academy of Medical Sciences，Beijing, 100037, China；No.167 North Lishi Road, Xicheng District, Beijing, China
• ¹⁷ Third Affiliated Hospital of Naval Medical University；No. 700, Moyu North Road, Jiading District, Shanghai 201800, China
• ¹⁸ Department of Pharmacy, Second Xiangya Hospital of Central South University, 139 Renmin Road, Furong District, Changsha 410011, China
• ¹⁹ Department of Pharmacy, The Fourth People's Hospital of Chengdu, Chengdu 610036, China

Background: Pediatric thrombosis is a relatively rare but severe condition in the field of pediatrics, with far-reaching consequences. Recent studies have indicated a rising incidence of this disease in children over the years. Additionally, the pharmacological treatment of thrombotic diseases in children faces numerous challenges. Due to significant physiological differences between children and adults, guidelines for the prevention and treatment of thrombotic diseases in adults cannot be directly applied to pediatric patients.Purpose: A systematic review of the existing evidence-based medical literature should be conducted to propose pharmacological prevention and treatment recommendations for pediatric thrombotic diseases. Developing a comprehensive and practical pharmacotherapy guideline for the prevention and treatment of pediatric thrombotic diseases is essential to enhancing the rational use of medications in managing these conditions in children.The guideline development followed the World Health Organization's (WHO)Handbook for Guideline Development. This involves systematically searching and extensively collecting data on common medication issues in the prevention and treatment of pediatric thrombosis nationwide. The Delphi method was used to survey experts and identify the clinical issues to be included. Subsequently, a systematic literature review was conducted to evaluate existing primary studies, systematic reviews, and guidelines or consensus statements from professional organizations. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The Delphi method was employed again to reach a consensus on the recommendations and evidence levels.This process was culminated in the development of the Guideline for Pharmacological Management of Thrombotic Diseases in Children.During the guideline development process, a total of 29 clinical issues were collected and evaluated by 78 experts in clinical pharmacy and clinical medicine.Through two rounds of surveys, 13 clinical issues were selected. Under the supervision of two methodologists, 13 clinical pharmacotherapy recommendations were formulated.By conducting a comprehensive assessment of the feasibility and safety of clinical practices, the guideline provides specific anticoagulant medication recommendations for pediatric healthcare professionals. This will help enhance the prevention and treatment of pediatric thrombosis, promoting more standardized and effective medical practices.