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[Symbol: see text]infants aged 0-12[Symbol: see text]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[Symbol: see text]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.
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[Symbol: see text]infants aged 0-12[Symbol: see text]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[Symbol: see text]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.
Authors: I K Jang; H K Gold; A A Ziskind; J T Fallon; R E Holt; R C Leinbach; J W May; D Collen Journal: Circulation Date: 1989-04 Impact factor: 29.690
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Johan Groeneveld; Goran Hedenstierna; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Philipp Metnitz; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2008-02-29 Impact factor: 17.440
Authors: Walter Knirsch; Christian Kellenberger; Sven Dittrich; Peter Ewert; Martin Lewin; Reinald Motz; Jan Nürnberg; Oliver Kretschmar Journal: Pediatr Cardiol Date: 2012-09-09 Impact factor: 1.655