Recommendations for developing uniform laboratory monitoring of heparinoid anticoagulants in children

Newall, Fiona; Chan, Anthony; Ignjatović, Vera; Monagle, Paul

doi:10.1111/j.1538-7836.2011.04561.x

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…The variability in age-related pharmacokinetic parameter estimates (clearance, volume of distribution and half-life) leads to a different pharmacodynamics profile for anticoagulants in children in comparing to adults [ 116 , 156 ]. The 9 th edition of the ACCP guidelines recommend that in neonates or children receiving therapeutic LMWHs either once or twice daily the drug should be monitored to a target anti-Xa of 0.5–1.0 IU/mL in a sample taken 4–6 hours or 0.5–0.8 IU/mL in a sample taken 2–6 hours after subcutaneous injection [ 157 ].…”

Section: Biological Monitoring Of Anticoagulant Treatmentsmentioning

confidence: 99%

“…There is a need for robust pharmacodynamics models in pediatric practice. The current recommendations regarding anticoagulant dosing or laboratory monitoring in children are simply extrapolated from adult evidence and are not based on appropriately robust levels of evidence [ 156 ]. Therapeutic ranges are not well correlated with clinical outcomes and assays are not standardized.…”

Section: Biological Monitoring Of Anticoagulant Treatmentsmentioning

confidence: 99%

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Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays

et al. 2014

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Traditional anticoagulant agents such as vitamin K antagonists (VKAs), unfractionated heparin (UFH), low molecular weight heparins (LMWHs) and fondaparinux have been widely used in the prevention and treatment of thromboembolic diseases. However, these agents are associated with limitations, such as the need for regular coagulation monitoring (VKAs and UFH) or a parenteral route of administration (UFH, LMWHs and fondaparinux).Several non-VKA oral anticoagulants (NOACs) are now widely used in the prevention and treatment of thromboembolic diseases and in stroke prevention in non-valvular atrial fibrillation. Unlike VKAs, NOACs exhibit predictable pharmacokinetics and pharmacodynamics. They are therefore usually given at fixed doses without routine coagulation monitoring. However, in certain patient populations or special clinical circumstances, measurement of drug exposure may be useful, such as in suspected overdose, in patients experiencing a hemorrhagic or thromboembolic event during the treatment’s period, in those with acute renal failure, in patients who require urgent surgery or in case of an invasive procedure. This article aims at providing guidance on laboratory testing of classic anticoagulants and NOACs.Electronic supplementary materialThe online version of this article (doi:10.1186/1477-9560-12-24) contains supplementary material, which is available to authorized users.

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Section: Biological Monitoring Of Anticoagulant Treatmentsmentioning

confidence: 99%

Section: Biological Monitoring Of Anticoagulant Treatmentsmentioning

confidence: 99%

Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays

et al. 2014

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“…An anti‐Factor Xa level is accepted to be a better measure of heparin effect than the PTT . This is thought to be especially true in pediatrics given the effect of age on the PTT although recent studies have suggested that challenges exist with both methods in children . Thromboelastography is hypothesized to provide an accurate assessment of in vivo hemostasis with the R ‐value reflecting UFH anticoagulant effect .…”

Section: Antithrombotic Therapy Guidelines In Childrenmentioning

confidence: 99%

Antithrombotic therapy for ventricular assist devices in children: do we really know what to do?

Massicotte

Bauman

Murray

et al. 2015

Journal of Thrombosis and Haemostasis

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To cite this article: Massicotte MP, Bauman ME, Murray J, Almond CS. Antithrombotic therapy for ventricular assist devices in children: do we really know what to do? J Thromb Haemost 2015; 13 (Suppl. 1): S343-S50.Summary. The use of ventricular assist devices (VADs) in children is increasing. Stroke and device-related thromboembolism remain the most feared complications associated with VAD therapy in children. The presence of a VAD causes dysregulation of hemostasis due to the presence of foreign materials and sheer forces intrinsic to the device resulting in hypercoagulability and potentially lifethreatening thrombosis. The use of antithrombotic therapy in adults with VADs modulates this disruption in hemostasis, decreasing the risk of thrombosis. Yet, differences in hemostasis in children (developmental hemostasis) may result in variances in dysregulation by these devices and preclude the use of adult guidelines. Consequently, pediatric device studies must include safety and efficacy estimates of device-specific antithrombotic therapy guidelines. This review will discuss mechanisms of hemostatic dysregulation as it pertains to VADs, goals of VAD antithrombotic therapy for children and adults, and emerging antithrombotic strategies for VAD use in children.

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Pediatrics

Bauman

Bruce

Massicotte

2016

Practical Hemostasis and Thrombosis

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Recommendations for developing uniform laboratory monitoring of heparinoid anticoagulants in children

Cited by 7 publications

References 19 publications

Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays

Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays

Antithrombotic therapy for ventricular assist devices in children: do we really know what to do?

Pediatrics

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