Novel paediatric anticoagulants: a review of the current literature

Chan, Veronica H T; Monagle, Paul; Massicotte, Patti; Chan, Anthony K.C.

doi:10.1097/mbc.0b013e328335f1d2

Cited by 27 publications

(20 citation statements)

References 49 publications

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“…Presumed HIT currently is the most common indication for children to receive novel anticoagulant drugs, and the outcome for these children often is poor because of complications of the novel anticoagulants. 71 Danaparoid, hirudin, and argatroban are alternatives to UFH in children with HIT. 65,72-99…”

Section: Pharmacokineticsmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

Self Cite

1,268

559

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Section: Pharmacokineticsmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

Self Cite

1,268

559

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“…These drugs specifically target FIIa and have the advantage that they do not require cofactors like AT to function; nor are they neutralized by PF4 like heparin [71]. Furthermore, they are small molecules and can bind to FIIa that is currently enmeshed in a clot as well as FIIa in the plasma (i.e., soluble and insoluble thrombin).…”

Section: Direct Thrombin Inhibitorsmentioning

confidence: 99%

“…The half-life of argatroban is ∼50 minutes, and it is cleared solely through hepatic mechanisms, making it suitable for use in patients with acute renal failure. Anticoagulation monitoring is typically performed through the activated thromboplastin time (aPTT) test because argatroban can lead to false increases in the international normalised ratio (INR) level [71].…”

Section: Argatrobanmentioning

confidence: 99%

“…Of all the DTIs, argatroban has seen the greatest clinical use in the settings of cardiopulmonary bypass and ECMO for patients with confirmed or suspected HIT [71,73,74]. Dosing for argatroban in these therapies ranges from 0.1-250 μg/kg loading dose depending on the setting (CPB vs PCI), patient age (neonates may require a smaller bolus because their thrombin generation is lower than adults [75]), and physician experience, or 10-30 μg in an extracorporeal circuit.…”

Section: Argatrobanmentioning

confidence: 99%

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ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

Maul¹,

Massicotte²,

Wearden³

2016

Extracorporeal Membrane Oxygenation: Advances in Therapy

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The interaction between the patient and the ECMO (extracorporeal membrane oxygenation) circuit initiates a significant coagulation and inflammatory response due to the large surface area of foreign material contained within the circuit. This response can be blunted with the appropriate mix of biocompatible materials and anticoagulation therapy. The use of anticoagulants, in turn, requires appropriate laboratory testing to determine whether the patient is appropriately anticoagulated. Physicians must balance the risks of bleeding with the risks of thrombosis; the proper interpretation of these tests is often shrouded in mystery. It is the purpose of this chapter to help demystify the coagulation system, anticoagulants, biocompatible surfaces, and coagulation testing so that ECMO practitioners can make informed decisions about their patients and to spur coordinated efforts for future research to improve our understanding of these complex processes.

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“…Para el diagnóstico de la enfermedad es importante la confirmación ecográfica, pero como el tratamiento quirúrgico para trombos intracardíacos en los recién nacidos se asocia con alta mortalidad, se prefiere el manejo médico, pudiendo ser la única modalidad viable de tratamiento en algunos casos. Los últimos estudios han evaluado la anticoagulación en los niños desde el punto de vista de las complicaciones de los agentes antitrombóticos disponibles 4,5 . Entre los tratamientos disponibles esta la estreptoquinasa, uroquinasa y activador de plasminógeno tisular recombinante (r-TPA), pero la Heparina de bajo peso molucular (HBPM), aunque no es un trombolítico sino un anticoagulante, puede ser una opción terapéutica para la trombosis en neonatos de alto riesgo.…”

Section: Introductionunclassified

Trombosis de vena cava inferior y endocarditis en un paciente prematuro: Caso clínico

Buitrago

Zuluaga

Murillo

2014

Rev. chil. pediatr.

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inferior vena cava thrombosis and endocarditis in a premature patient -Case reportThrombosis of the inferior vena cava represents a significant percentage of all venous thrombosis that take place during the neonatal period, generally associated with risk factors such as the use of central venous catheter. The incidence of bacterial endocarditis in preterm infants is low. objectives: To characterize the case of a preterm neonate with both conditions and to detail the disease changing spectrum in the neonatal population and its therapeutic possibilities. Case report: Premature newborn, 31 + 5 weeks of gestation who presented Enterococcus faecalis bacteremia, developed progressive thrombosis of the inferior vena cava and right atrium secondary to the use of umbilical venous catheter, with subsequent diagnosis of endocarditis. He was treated with anticoagulation with subcutaneous low molecular weight heparin. Given a favorable evolution, it was decided to continue the anticoagulation therapy for 4-6 weeks, and at the time of discharge, aspirin treatment was given. Conclusions: The preterm infant with infective endocarditis and intracardiac thrombus presents an interesting management dilemma. Treatment should be individualized according to the clinical evolution and safety profile of thrombolytic and/or anticoagulant agents. Availability and advantages of low molecular weight heparin have led to its use as an alternative treatment in neonates and infants with deep venous thrombosis. (Key words: Neonatal bacteremia, central venous catheter, endocarditis, thrombosis). Rev Chil Pediatr 2014; 85 (6): 708-713 resumen La trombosis de la vena cava inferior corresponde a un porcentaje importante de las trombosis venosas en la etapa neonatal, generalmente asociado a factores de riesgo como el uso de catéter venoso central. La incidencia de endocarditis bacteriana en recién nacidos prematuros es baja. objetivos: Caracterizar el caso de un neonato pretérmino en que se asociaron ambas patologías y detallar el espectro cambiante de esta enfermedad en la población neonatal y sus posibilidades terapéuticas. Caso clínico: Recién nacido prematuro de 31 + 5 semanas de gestación, que presentó bacteriemia por Enterococo faecalis, evolucionó con trombosis progresiva de la vena cava inferior y aurícula derecha secundaria al uso de catéter venoso umbilical, con posterior diagnóstico de endocarditis. Se manejó con anticoagulación con heparina de bajo peso molecular en forma subcutánea, CASO CLíNICO Rev Chil Pediatr 2014; 85 (6): 708-713

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Novel paediatric anticoagulants: a review of the current literature

Cited by 27 publications

References 49 publications

Antithrombotic Therapy in Neonates and Children

Antithrombotic Therapy in Neonates and Children

ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

Trombosis de vena cava inferior y endocarditis en un paciente prematuro: Caso clínico

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