Heparin Therapy in Pediatric Patients: A Prospective Cohort Study

摘要: Current guidelines for heparin therapy in pediatric patients have been extrapolated from trials adult without rigorous evaluation of efficacy and safety. We prospectively monitored consecutive receiving systemic doses over 10 mo at one institution using a predetermined nomogram to monitor maintenance therapy. Sixty-five children; 38 males 27 females, received heparin. Thirty children had deep venous thrombosis and/or pulmonary embolism; 11 arterial thrombi, most frequently after diagnostic angiography; the remaining 24 prophylactically, congenital heart disease. Twenty-nine (45%) 65 were less than 1 y age 22 (34%) or older. Congenital disease was predominant diagnosis under older children. After bolus dose 50 U/kg, 39% (n = 30) achieved minimal level activated partial thromboplastin time (APTT). Sixty-eight percent APTT by h 81% 48 h. For all children, values within therapeutic range 43% time. outside twice as likely be low high. The average amount required maintain U/kg/h: 28 U/kg/h infants < 20 rest. Bleeding rare (2%) mild. Documented recurrent thrombotic more common (7%) with associated morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)