Bivalirudin for anticoagulation in children
| Autor: | Guy Young, Sobharani Rayapudi, Mitchell P. Ross, Girish Deshpande, Michael D. Tarantino, Adalberto Torres, Julie Wohrley |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Adolescent medicine.drug_class Low molecular weight heparin Antithrombins Medicine Bivalirudin Humans Thrombus Child Retrospective Studies medicine.diagnostic_test business.industry Heparin Antithrombin Infant Newborn Anticoagulants Infant Thrombosis Hematology Hirudins medicine.disease Thrombocytopenia Peptide Fragments Recombinant Proteins Treatment Outcome Oncology Anesthesia Child Preschool Pediatrics Perinatology and Child Health Female business Discovery and development of direct thrombin inhibitors medicine.drug Partial thromboplastin time |
| Zdroj: | Pediatric bloodcancer. 51(6) |
| ISSN: | 1545-5017 |
| Popis: | Background Thromboembolism in children is typically treated with unfractionated heparin (UH) or low molecular weight heparin (LMWH). Both rely on antithrombin (AT) for their action. In addition, heparin-induced thrombocytopenia (HIT) is a potentially serious complication of heparin use in children. Bivalirudin or other direct thrombin inhibitors may be a useful alternative to heparins in treating thrombosis in children. Procedure We report a retrospective review to assess the efficacy and safety of bivalirudin in pediatric patients with thrombosis. Results Sixteen children received bivalirudin for thrombosis or prevention of thrombosis at the Children's Hospital of Illinois from January 2005 to January 2007. Patients received a bolus dose of 0.25 mg/kg followed by a continuous infusion (0.16 ± 0.07 mg kg−1 hr−1) titrated to 1.5–2.5 times the baseline activated partial thromboplastin time (aPTT). Positive correlation between the bivalirudin average infusion rate and aPTT was observed in twelve patients. Ultrasonographic evidence of thrombus regression was noted at 72 hr in 10 of 10 patients. One patient experienced hematuria after catheterization of the urethra. Conclusion Bivalirudin was effective and well-tolerated in these patients. Further studies should be conducted to better define safety and efficacy of bivalirudin in pediatric patients. Pediatr Blood Cancer 2008;51:798–801. © 2008 Wiley-Liss, Inc. |
| Databáze: | OpenAIRE |
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