Document Detail


Use of low molecular mass heparin (enoxaparin) in newborn infants: a prospective cohort study of 62 patients.
MedLine Citation:
PMID:  12937038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To detail low molecular mass heparin (enoxaparin) use in the first few months of life. DESIGN: Prospective, consecutive cohort of unselected newborn infants. METHODS: Newborn infants were divided into groups by gestational age, underlying condition, hepatic and renal function, thrombocytopenia, and prothrombin time (PT/INR). Groups were analysed with respect to many aspects of enoxaparin treatment using multivariate methods. RESULTS: Sixty two newborn infants received enoxaparin representing 5.39 treatment years. Thromboembolic events (TEs) occurred predominantly in the lower and upper venous system in the presence of indwelling catheters (69%). Preterm infants required longer than full term infants to achieve an anti-(factor Xa) level in the target range (six versus two days). Preterm infants required higher doses of enoxaparin than full term infants to maintain anti-(factor Xa) levels in the target range (2.1 v 1.7 mg/kg/12 h). Infants with congenital heart disease (CHD) required less enoxaparin than those without CHD to maintain an anti-(factor Xa) level in the target range (1.7 v 2.1 mg/kg/12 h). Impaired renal and liver function influenced the number of dose changes needed (three versus one a month). Complete or partial resolution of TE was accomplished in 59% of newborn infants. Four infants developed major bleeds (1.2% per patient year). Recurrent TE and clot extension occurred in three infants (0.9% per patient year). CONCLUSIONS: Preterm infants are more difficult to treat with enoxaparin than full term infants. Enoxaparin appears to be an alternative to treatment with standard heparin or no treatment.
Authors:
W Streif; G Goebel; A K C Chan; M P Massicotte
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  88     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-25     Completed Date:  2003-11-12     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F365-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Innsbruck, Austria. Werner.Streif@uibk.ac.at
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage*,  adverse effects
Antithrombin III / analysis
Catheters, Indwelling
Cohort Studies
Coronary Disease / complications
Dose-Response Relationship, Drug
Enoxaparin / administration & dosage*,  adverse effects
Female
Heart Defects, Congenital / complications
Hemorrhage / chemically induced
Humans
Infant, Newborn
Infant, Premature, Diseases / prevention & control*
Male
Prospective Studies
Recurrence
Thromboembolism / etiology,  prevention & control*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 9000-94-6/Antithrombin III
Comments/Corrections

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


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