Utilization practices of low molecular weight heparin in pediatric patients with acquired and congenital heart disease

Ankola, Ashish A.; Ghbeis, Muhammad B.; Bailey, Brianna; Sahakian, Lori; Hellinger, Amy; Hawkins, Beth; Ventresco, Courtney; Blume, Elizabeth D.; VanderPluym, Christina

doi:10.1016/j.ppedcard.2021.101346

Cited by 1 publication

(4 citation statements)

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“…The use of EX both in prophylactic and therapeutic management is slowly becoming the procedure of choice in paediatric patients, and is increasingly recommended in newborns due to its easy dosing, low number of complications and rare interactions with other drugs and nutrients [29,30].…”

Section: Discussionmentioning

confidence: 99%

“…In neonates, EX can be administered deeply subcutaneously in undiluted form, intravenously diluted with 0.9% NaCl in the schedule of 1 mg EX in 1 ml of 0.9% NaCl and into the arterial line of extracorporeal circulation. Intramuscular administration is contraindicated [29,55,56,75].…”

Section: Methods Of Enoxaparin Administrationmentioning

confidence: 99%

“…The use of EX, like other LMWHs, is slowly becoming the treatment of choice in paediatric patients and is increasingly recommended in newborns. LMWHs have an advantage over non-fractionated heparin (NFH) due to easier monitoring, fewer complications and less frequent interactions with other drugs and nutrients [29,30].…”

Section: Frequency Of Coagulation Parameters Monitoringmentioning

confidence: 99%

“…EX metabolism occurs mainly in the liver by breaking disulphide bonds and depolymerization [28]. Due to the ease of use and favourable pharmacokinetic parameters, among LMWH it is EX that is recommended in TECs therapy in newborns [29,30].…”

Section: Introductionmentioning

confidence: 99%

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Thromboembolic complications in newborns – diagnostic value of D-dimers concentration and proposed outline of enoxaparin use

Wątroba¹,

Bryda²

2022

J Pre Clin Clin Res.

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Introduction and Objective. Among paediatric patients, thromboembolic complications (TECs) are most often observed in newborns, especially premature infants requiring intensive care and the use of central vascular accesses. Prognosis depends on the presence of comorbidities, maturity of the newborn, and the location and size of the thrombus. The basic laboratory test that allows for the exclusion of TECs is assessment of the plasma D-dimers concentration, the correct value of which sufficiently excludes the presence of TECs. Review methods. The review attempts to systematize existing knowledge on the plasma D-dimers concentration in newborns, and creates a scheme for using enoxaparin (EX), helpful in everyday clinical practice. Brief description of the state of knowledge. There are single studies devoted to assessing the plasma D-dimers concentration in newborns, but they agree that the concentration in normal healthy adults does not apply to newborns, regardless of the postmenstrual age (PMA), because the plasma D-dimers concentration found in newborns are significantly higher, despite the lack of clinical and ultrasound features of thrombosis and normal results of other parameters of the coagulation system. Increased plasma D-dimers concentration in newborns may be due to delayed renal clearance of D-dimers and to physiological mechanisms related to the closing of the venous duct (DV) and arterial duct (DA) in the newborn. Summary. Plasma D-dimers concentration is one of the basic laboratory markers of TECs, and is a starting point for further diagnostics and a valuable guide when making decisions about prophylactic and therapeutic procedures. The use of EX, as well as other LMWHs, is slowly becoming the treatment of choice in paediatric patients and is increasingly more often recommended in newborns.

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Section: Discussionmentioning

confidence: 99%