Lack of correlation between heparin dose and standard clinical monitoring tests in treatment with unfractionated heparin in critically ill children

Haematologica. 2007 Apr;92(4):554-7. doi: 10.3324/haematol.10696.

Abstract

The activated partial thromboplastin time (aPTT) and anti-Xa activity are used for monitoring unfractionated heparin (UFH) therapy in children and may not be optimal.

Objective: Determine correlations of aPTT, anti-Xa and UFH dose in children. Single centre prospective cohort study in children receiving UFH. The aPTT and anti-Xa results from routine coagulation monitoring were collected. Thirty-nine children (median age 18 days) were enrolled. There was no relationship between aPTT and UFH dose (r2=0.12) or anti-Xa and UFH dose (r2=0.03) or aPTT and anti-Xa (r2=0.22). aPTT and anti-Xa do not accurately monitor UFH therapy in children.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use
  • Blood Coagulation Tests*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Critical Care / methods*
  • Dose-Response Relationship, Drug
  • Drug Monitoring
  • Factor Xa Inhibitors*
  • Female
  • Heart Defects, Congenital / blood
  • Hemorrhage / chemically induced
  • Heparin / administration & dosage*
  • Heparin / adverse effects
  • Heparin / pharmacology
  • Heparin / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Partial Thromboplastin Time
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Pulmonary Embolism / drug therapy
  • Thrombin
  • Thrombophilia / drug therapy
  • Thrombosis / prevention & control
  • Venous Thrombosis / drug therapy

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Heparin
  • Thrombin