title: Evaluation of the use of low-molecular-weight heparin in neonates: a retrospective, single-center study.
abstract: Controversies exist over the currently recommended guidelines for the use of low-molecular-weight heparin (LMWH) in neonates. We retrospectively studied 30 neonates treated with LMWH and found a poor therapeutic response to recommended doses as measured by anti-Xa levels. Sixty percent of the study participants required their doses to be increased because of subtherapeutic anti-Xa levels during the initial course of their treatment. The mean starting enoxaparin dose was 1.53 ± 0.38 mg/kg. The mean enoxaparin dose, once therapeutic anti-Xa levels had been achieved, was 1.86 ± 0.50 mg/kg. Preterm and term infants required doses of 2.06 ± 0.61 mg/kg and 1.67 ± 0.26 mg/kg, respectively, to achieve therapeutic anti-Xa levels. In summary, our results suggest that higher initial doses are required to achieve therapeutic anticoagulation in neonates.
authors.affiliation: 1Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Ankush
authors.initials: A
authors.lastname: Chander
authors.forename: Kim
authors.initials: K
authors.lastname: Nagel
authors.forename: John
authors.initials: J
authors.lastname: Wiernikowski
authors.forename: Bosco
authors.initials: B
authors.lastname: Paes
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Chan
mesh_terms: D015331:Cohort Studies; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D013927:Thrombosis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D006495:Heparin, Low-Molecular-Weight
keywords: anticoagulants; clinical pharmacology; heparins; low-molecular-weight heparins; pediatric thrombosis; thrombosis