Lack of correlation between heparin dose and standard clinical monitoring tests in treatment with unfractionated heparin in critically ill children.
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.
Kuhle
Stefan
S
Division of Haematology/Oncology, Department of Population Health Sciences, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Eulmesekian
Pablo
P
Kavanagh
Brian
B
Massicotte
Patricia
P
Vegh
Patsy
P
Lau
Alice
A
Mitchell
Lesley G
LG
D000293:Adolescent; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D065427:Factor Xa Inhibitors; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010314:Partial Thromboplastin Time; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000188:drug therapy; D013917:Thrombin; D019851:Thrombophilia / Q000188:drug therapy; D013927:Thrombosis / Q000517:prevention & control; D020246:Venous Thrombosis / Q000188:drug therapy
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006493:Heparin; D013917:Thrombin