Unfractionated heparin dosing in young infants: Clinical outcomes in a cohort monitored with anti-factor Xa levels

Journal of Thrombosis and Haemostasis

Volumn 10, Issue 3, 2012, Pages 368-374

  Schechter, T ^a   Finkelstein, Y ^a   Ali, M ^a   Kahr, W H ^a   Williams, S ^a   Chan, A K ^b   Deveber, G ^a   Brandao L R ^a  

^a HOSPITAL FOR SICK CHILDREN   (Canada)

^b MCMASTER UNIVERSITY   (Canada)

Author keywords

Heparin; Infants; Pediatrics

Indexed keywords

BLOOD CLOTTING FACTOR 10A ANTIBODY; HEPARIN; PROTEIN ANTIBODY; UNCLASSIFIED DRUG;

ARTICLE; BLEEDING; DRUG DOSE ESCALATION; DRUG MONITORING; EXTRACORPOREAL OXYGENATION; HUMAN; INFANT; MAJOR CLINICAL STUDY; OUTCOME ASSESSMENT; PARTIAL THROMBOPLASTIN TIME; PRIORITY JOURNAL; RISK FACTOR; TREATMENT DURATION; TREATMENT OUTCOME;

AGE FACTORS; ANTICOAGULANTS; BLOOD COAGULATION; BLOOD COAGULATION TESTS; CHI-SQUARE DISTRIBUTION; DRUG DOSAGE CALCULATIONS; DRUG MONITORING; FACTOR XA; FEMALE; FIBRINOLYTIC AGENTS; HEMORRHAGE; HEPARIN; HOSPITALS, PEDIATRIC; HUMANS; INFANT; INFANT, NEWBORN; LOGISTIC MODELS; MALE; ODDS RATIO; ONTARIO; PARTIAL THROMBOPLASTIN TIME; PREDICTIVE VALUE OF TESTS; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; THROMBOSIS; TREATMENT OUTCOME;

EID: 84863402272     PISSN: 15387933     EISSN: 15387836     Source Type: Journal    
DOI: 10.1111/j.1538-7836.2012.04624.x     Document Type: Article

References (35)

1. Monagle P, Chalmers E, Chan A, Deveber G, Kirkham F, Massicotte P, Michelson AD. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edn). Chest 2008; 133: 887S-968S.
2. Sutor AH, Massicotte P, Leaker M, Andrew M. Heparin therapy in pediatric patients. Semin Thromb Hemost 1997; 23: 303-19.
3. Hirsh J, Warkentin TE, Raschke R, Granger C, Ohman EM, Dalen JE. Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing considerations, monitoring, efficacy, and safety. Chest 1998; 114: 489S-510S.
4. Basu D, Gallus A, Hirsh J, Cade J. A prospective study of the value of monitoring heparin treatment with the activated partial thromboplastin time. N Engl J Med 1972; 287: 324-7.
5. Andrew M, Marzinotto V, Massicotte P, Blanchette V, Ginsberg J, Brill-Edwards P, Burrows P, Benson L, Williams W, David M, Poon A, Sparling K. Heparin therapy in pediatric patients: a prospective cohort study. Pediatr Res 1994; 35: 78-83.
6. Andrew M, Paes B, Milner R, Johnston M, Mitchell L, Tollefsen DM, Powers P. Development of the human coagulation system in the full-term infant. Blood 1987; 70: 165-72.
7. Andrew M, Paes B, Milner R, Johnston M, Mitchell L, Tollefsen DM, Castle V, Powers P. Development of the human coagulation system in the healthy premature infant. Blood 1988; 72: 1651-7.
8. Andrew M, Paes B, Johnston M. Development of the hemostatic system in the neonate and young infant. Am J Pediatr Hematol Oncol 1990; 12: 95-104.
9. McDonald MM, Jacobson LJ, Hay WW Jr, Hathaway WE. Heparin clearance in the newborn. Pediatr Res 1981; 15: 1015-18.
10. Turner-Gomes SNE, Benson L, Burrows P, Andrew M. Heparin is cleared faster in children with congenital heart disease than in adults. J Am Coll Cardiol 1993; 21: 59A.
11. Monagle P, Chan AKC, Deveber G, Massicotte MP. Antithrombotic therapy in children. In: Inc BD, ed. Thromboembolism and stroke, 3rd edn. BC Decker, Hamilton, ON, Canada, 2006: 75-84.
12. Revel-Vilk S, Sharathkumar A, Massicotte P, Marzinotto V, Daneman A, Dix D, Chan A. Natural history of arterial and venous thrombosis in children treated with low molecular weight heparin: a longitudinal study by ultrasound. J Thromb Haemost 2004; 2: 42-6.
13. Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3: 692-4.
14. Monagle P, Adams M, Mahoney M, Ali K, Barnard D, Bernstein M, Brisson L, David M, Desai S, Scully MF, Halton J, Israels S, Jardine L, Leaker M, McCusker P, Silva M, Wu J, Anderson R, Andrew M, Massicotte MP. Outcome of pediatric thromboembolic disease: a report from the Canadian Childhood Thrombophilia Registry. Pediatr Res 2000; 47: 763-6.
15. Schmidt B, Andrew M. Neonatal thrombosis: report of a prospective Canadian and International Registry. Pediatrics 1995; 96: 939-43.
16. Nowak-Gottl U, von Kries R, Gobel U. Neonatal symptomatic thromboembolism in Germany: two year survey. Arch Dis Child Fetal Neonatal Ed 1997; 76: F163-7.
17. Kuhle S, Massicotte P, Chan A, Adams M, Abdolell M, de Veber G, Mitchell L. Systemic thromboembolism in children. Data from the 1-800-NO-CLOTS Consultation Service. Thromb Haemost 2004; 92: 722-8.
18. Barnard DR, Hathaway WE. Neonatal thrombosis. Am J Pediatr Hematol Oncol 1979; 1: 235-44.
19. Ignjatovic V, Summerhayes R, Than J, Gan A, Monagle P. Therapeutic range for unfractionated heparin therapy: age-related differences in response in children. J Thromb Haemost 2006; 4: 2280-2.
20. Ignjatovic V, Furmedge J, Newall F, Chan A, Berry L, Fong C, Cheng K, Monagle P. Age-related differences in heparin response. Thromb Res 2006; 118: 741-5.
21. Newall F, Ignjatovic V, Summerhayes R, Gan A, Butt W, Johnston L, Monagle P. In vivo age dependency of unfractionated heparin in infants and children. Thromb Res 2009; 123: 710-14.
22. Ignjatovic V, Straka E, Summerhayes R, Monagle P. Age-specific differences in binding of heparin to plasma proteins. J Thromb Haemost 2010; 8: 1290-4.
23. Andrew M, Ofosu F, Schmidt B, Brooker L, Hirsh J, Buchanan MR. Heparin clearance and ex vivo recovery in newborn piglets and adult pigs. Thromb Res 1988; 52: 517-27.
24. Chan AK, Black L, Ing C, Brandao LR, Williams S. Utility of aPTT in monitoring unfractionated heparin in children. Thromb Res 2008; 122: 135-6.
25. Kuhle S, Eulmesekian P, Kavanagh B, Massicotte P, Vegh P, Mitchell LG. A clinically significant incidence of bleeding in critically ill children receiving therapeutic doses of unfractionated heparin: a prospective cohort study. Haematologica 2007; 92: 244-7.
26. Ignjatovic V, Summerhayes R, Gan A, Than J, Chan A, Cochrane A, Bennett M, Horton S, Shann F, Lane G, Ross-Smith M, Monagle P. Monitoring unfractionated heparin (UFH) therapy: which anti-factor Xa assay is appropriate? Thromb Res 2007; 120: 347-51.
27. Rosborough TK, Shepherd MF. Achieving target antifactor Xa activity with a heparin protocol based on sex, age, height, and weight. Pharmacotherapy 2004; 24: 713-19.
28. Hull RD, Raskob GE, Hirsh J, Jay RM, Leclerc JR, Geerts WH, Rosenbloom D, Sackett DL, Anderson C, Harrison L, Gent M. Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. N Engl J Med 1986; 315: 1109-14.
29. Turpie AG, Robinson JG, Doyle DJ, Mulji AS, Mishkel GJ, Sealey BJ, Cairns JA, Skingley L, Hirsh J, Gent M. Comparison of high-dose with low-dose subcutaneous heparin to prevent left ventricular mural thrombosis in patients with acute transmural anterior myocardial infarction. N Engl J Med 1989; 320: 352-7.
30. Anand S, Ginsberg JS, Kearon C, Gent M, Hirsh J. The relation between the activated partial thromboplastin time response and recurrence in patients with venous thrombosis treated with continuous intravenous heparin. Arch Intern Med 1996; 156: 1677-81.
31. Newall F, Ignjatovic V, Johnston L, Summerhayes R, Lane G, Cranswick N, Monagle P. Clinical use of unfractionated heparin therapy in children: time for change? Br J Haematol 2010; 150: 674-8.
32. Nieuwenhuis HK, Albada J, Banga JD, Sixma JJ. Identification of risk factors for bleeding during treatment of acute venous thromboembolism with heparin or low molecular weight heparin. Blood 1991; 78: 2337-43.
33. Massicotte P, Julian JA, Gent M, Shields K, Marzinotto V, Szechtman B, Andrew M. An open-label randomized controlled trial of low molecular weight heparin compared to heparin and coumadin for the treatment of venous thromboembolic events in children: the REVIVE trial. Thromb Res 2003; 109: 85-92.
34. Avila MLSV, Brandao LR. Heparin-induced-thrombocytopenia in children: a systematic review identifying literature gaps and pitfalls. J Thromb Haemost 2011; 9 (Suppl. 2): O-TU-048.
35. Bauman ME, Bauman ML, Black KL, Bajzar L, Massicotte P. Clot resolution in children younger than 3 months of age implies active fibrinolysis. Can J Cardiol 2009; 25 (Suppl SB): 0444.