Erschienen in:
01.11.2007 | Pediatric Original
Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease
verfasst von:
Joe Bontadelli, Alexander Moeller, Markus Schmugge, Thomas Schraner, Oliver Kretschmar, Urs Bauersfeld, Vera Bernet-Buettiker, Manuela Albisetti
Erschienen in:
Intensive Care Medicine
|
Ausgabe 11/2007
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Abstract
Objective
To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease.
Design
Prospective observational study.
Setting
Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich.
Patients
A cohort of 32 infants aged 0–12 months treated with enoxaparin for catheter-related arterial thrombosis from 2002 to 2005.
Measurements
Dose requirements of enoxaparin, resolution of thrombosis by Doppler ultrasound, and bleeding complications.
Results
Catheter-related arterial thrombosis was located in the iliac/femoral arteries in 31 (97%) infants and aorta in 1 infant, and was related to indwelling catheters and cardiac catheterization in 17 (53%) and 15 (47%) cases, respectively. Newborns required increased doses of enoxaparin to achieve therapeutic anti-FXa levels (mean 1.62 mg/kg per dose) compared with infants aged 2–12 months (mean 1.12 mg/kg per dose; p = 0.0002). Complete resolution of arterial thrombosis occurred in 29 (91%) infants at a mean of 23 days after initiation of enoxaparin therapy. Partial or no resolution was observed in 1 (3%) and 2 (6%) infants, respectively, at a mean follow-up time of 4.3 months. Bleeding complications occurred in 1 (3%) infant.
Conclusion
Enoxaparin is efficient and safe for infants with congenital heart disease and catheter-related arterial thrombosis, possibly representing a valid alternative to the currently recommended unfractionated heparin.