Use of low molecular weight heparin for thromboprophylaxis in a pediatric inpatient population: Reasons for use and incidence of bleeding complications

Cavo, Matthew; Wang, Wei; O’Brien, Sarah H.

doi:10.1016/j.thromres.2009.03.004

Cited by 14 publications

(6 citation statements)

References 13 publications

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“…Instituting a policy for thromboprophylaxis in paediatric trauma patients has varied in impact within different centres, some reporting a reduction in incidence of VTE14 while others report no change in VTE rate despite increasing use of LMWH thromboprophylaxis over time 15. One study identified a major bleed rate of 4.3% with no reduction in VTE in children receiving LMWH thromboprophylaxis following trauma 16. Due to the low baseline rate of VTE in adolescents with trauma, estimated to be 0.08%–0.3%,9–13 and the absence of high quality evidence to support a role for LMWH in reducing incidence of VTE in this age group, it is not certain whether the burden of VTE outweighs the potential bleeding risk in relation to thromboprophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism occurring during adolescence

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Venous thromboembolism occurring during adolescence

et al. 2016

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“…Consistent with these survey results, we found a marked increase in the use of enoxaparin in adolescent trauma patients despite a stable incidence of VTE. The use of any anticoagulant is not without risks, and a recent study in pediatric patients demonstrated a 4% risk of major bleeding during prophylactic use of enoxaparin [12]. Consequently, it is important to determine subset populations that may benefit from VTE prophylaxis despite the added risks.…”

Section: Discussionmentioning

confidence: 99%

Increased use of enoxaparin in pediatric trauma patients

Askegard-Giesmann

O’Brien

Wang

et al. 2012

Journal of Pediatric Surgery

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“…[16][17][18][19][20][21][22][23] Table 3 summarizes study design, type of LMWH, daily dose, number treated, efficacy, and adverse events in children with VTE treated with LMWH in both the acute phase and for secondary prophylaxis following the acute phase treatment. 10,14,17,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Published data on the treatment of arterial thrombosis and ischemic stroke in children are summarized in Table 3. 26,[43][44][45] Apart from antiplatelet agents such as aspirin, LMWH has been successfully used in this indication.…”

Section: Descriptive Analysesmentioning

confidence: 99%

Safety and Efficacy of Low Molecular Weight Heparins in Children: A Systematic Review of the Literature and Meta-Analysis of Single-Arm Studies

Bidlingmaier¹,

Kenet

Kurnik³

et al. 2011

Semin Thromb Hemost

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Within the last two decades low molecular weight heparins (LMWH) have gained increasing widespread use as anticoagulants in children. The use of LMWH has been implemented into clinical care even though there is a lack of firm evidence on the efficacy and safety of LMWH in this population due to the absence of sufficiently powered randomized controlled trials. In the absence of clinical trials, we performed a meta-analysis of available single-arm studies using LMWH in children. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1980 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients, ethnicity, venous thromboembolic events type, and frequency of recurrence and major bleedings were abstracted. Pooled incidence rates (IR) including 95% confidence intervals (95% CIs) on efficacy and safety data of LMWH administration on primary prophylaxis, as well as on secondary prophylaxis in children following symptomatic thromboembolism (TE) were shown. We included 2251 pediatric patients derived from 35 single-arm studies from 12 study countries who were eligible for analysis in the present systematic review. Pooled incidence rates (95% CI) to develop first TE on primary prophylaxis, further TE event on LMWH secondary prophylaxis, or a major bleeding event on LMWH were 0.047 (0.023 to 0.091), 0.052 (0.037 to 0.073) for efficacy, and 0.054 (0.039 to 0.074) for safety (treatment data only), respectively. Efficacy and safety data are comparable with adult data. The present systematic review suggests that use of LMWH in children as primary prophylaxis and in treatment of symptomatic thrombosis is effective and safe. However, properly designed randomized controlled trials are needed.

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Use of low molecular weight heparin for thromboprophylaxis in a pediatric inpatient population: Reasons for use and incidence of bleeding complications

Cited by 14 publications

References 13 publications

Venous thromboembolism occurring during adolescence

Venous thromboembolism occurring during adolescence

Increased use of enoxaparin in pediatric trauma patients

Safety and Efficacy of Low Molecular Weight Heparins in Children: A Systematic Review of the Literature and Meta-Analysis of Single-Arm Studies

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