Antithrombotic therapy in children

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W Streif1, L G Mitchell, M Andrew

  • 1Hamilton Civic Hospital Research Centre, Ontario, Canada.

Current Opinion in Pediatrics
|March 20, 1999
PubMed

Insights

Pediatric thromboembolic events are common but understudied. This review details antithrombotic agents for children, highlighting differences from adult treatments and guiding optimal use.

Area of Science:

  • Pediatric Hematology
  • Thrombosis and Hemostasis
  • Pharmacology

Background:

  • Thromboembolic events are a growing complication in children with severe illnesses.
  • Pediatric clinical trials for antithrombotic agents are limited due to event rarity.
  • Current pediatric treatment guidelines are often extrapolated from adult data.

Purpose of the Study:

  • To review antithrombotic agents used in pediatric thromboembolism.
  • To discuss mechanisms, dosing, monitoring, and side effects of these agents in children.
  • To address the need for pediatric-specific antithrombotic strategies.

Main Methods:

  • Literature review of antithrombotic agents in pediatric populations.
  • Analysis of standard heparin, low molecular heparin, and oral anticoagulants.
  • Evaluation of thrombolytic therapy, antiplatelet agents, antithrombin, and protein C concentrates.

Main Results:

  • Commonly used antithrombotic agents in children include heparin, LMWH, oral anticoagulants, thrombolytics, antiplatelets, antithrombin, and protein C concentrates.
  • Key aspects discussed: mechanisms, dosing, monitoring, therapeutic ranges, dose-response factors, and adverse effects.
  • Significant differences exist between pediatric and adult responses to antithrombotic therapy.

Conclusions:

  • Optimal prevention and treatment of pediatric thromboembolism may differ from adult protocols.
  • Evidence-based guidelines tailored for children are crucial for effective antithrombotic therapy.
  • Further research is needed to establish pediatric-specific antithrombotic treatment strategies.

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