Low-molecular-weight heparin in pediatric patients with thrombotic disease: A dose finding study

摘要: Abstract OBJECTIVE: To compare low-molecular-weight preparations of heparin (LMWH) with standard in children requiring anticoagulant treatment for thromboembolic disease. METHODS: We treated 25 who required heparin, but were at significant risk bleeding, LMWH (enoxaparin, Rhone-Poulenc Rorer). The median age was 4 years (range, newborn to 17 years), nine infants less than 2 months age. Fourteen had a deep vein thrombosis or pulmonary embolism, thrombotic complications the central nervous system, and two complex congenital heart disease, which they received prophylaxis lower dosage (0.5 mg/kg given subcutaneously twice day). remaining 23 an initial dose 1 mg/kg, every 12 hours subcutaneously, subsequent doses adjusted achieve 4-hour anti-factor Xa level between 0.5 1.0 unit/ml. RESULTS: Newborn increased requirements; average 1.60 units/kg therapeutic levels. For children, sufficient. After adjustment, administered twice-weekly monitoring. duration therapy 14 days. Two previously documented gastrointestinal ulcers bled transfusion therapy. Therapy continued without further events. There no new events during LMWH. cost administering compared reduced by 30% because decreased laboratory monitoring, blood sampling times, intravenous starts, nursing time. Needle punctures placement subcutaneous catheter. CONCLUSION: These results provide basis randomized, controlled trial comparing pediatric patients. (J PEDIATR 1996; 128:313-8)