Document Detail


Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease.
MedLine Citation:
PMID:  17554520     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease. DESIGN: Prospective observational study. SETTING: Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich. PATIENTS: A cohort of 32[Symbol: see text]infants aged 0-12[Symbol: see text]months treated with enoxaparin for catheter-related arterial thrombosis from 2002 to 2005. MEASUREMENTS: Dose requirements of enoxaparin, resolution of thrombosis by Doppler ultrasound, and bleeding complications. RESULTS: Catheter-related arterial thrombosis was located in the iliac/femoral arteries in 31 (97%) infants and aorta in 1 infant, and was related to indwelling catheters and cardiac catheterization in 17 (53%) and 15 (47%) cases, respectively. Newborns required increased doses of enoxaparin to achieve therapeutic anti-FXa levels (mean 1.62[Symbol: see text]mg/kg per dose) compared with infants aged 2-12 months (mean 1.12 mg/kg per dose; p=0.0002). Complete resolution of arterial thrombosis occurred in 29 (91%) infants at a mean of 23 days after initiation of enoxaparin therapy. Partial or no resolution was observed in 1 (3%) and 2 (6%) infants, respectively, at a mean follow-up time of 4.3 months. Bleeding complications occurred in 1 (3%) infant. CONCLUSION: Enoxaparin is efficient and safe for infants with congenital heart disease and catheter-related arterial thrombosis, possibly representing a valid alternative to the currently recommended unfractionated heparin.
Authors:
Joe Bontadelli; Alexander Moeller; Markus Schmugge; Thomas Schraner; Oliver Kretschmar; Urs Bauersfeld; Vera Bernet-Buettiker; Manuela Albisetti
Publication Detail:
Type:  Journal Article     Date:  2007-06-07
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-24     Completed Date:  2008-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1978-84     Citation Subset:  IM    
Affiliation:
Division of Pediatrics, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage,  therapeutic use*
Cohort Studies
Coronary Thrombosis / drug therapy*,  epidemiology,  etiology
Enoxaparin / administration & dosage,  therapeutic use*
Female
Heart Catheterization / adverse effects
Heart Defects, Congenital / physiopathology*
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric
Male
Outcome Assessment (Health Care)
Switzerland / epidemiology
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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