Clinical experiences with low-molecular weight heparins in pediatric patients

Area of Science:

• Pediatric Thrombosis
• Pharmacology
• Hematology

Background:

• Thromboembolic events pose risks in children, especially post-surgery or trauma.
• Low-molecular weight heparins (LMWHs) are increasingly used in pediatric anticoagulation.
• Limited data exists on LMWH efficacy and safety in diverse pediatric populations.

Purpose of the Study:

• To retrospectively analyze the efficacy and safety of two LMWHs (nadroparin and enoxaparin) in pediatric patients.
• To evaluate LMWH use for short-term prophylaxis, long-term prophylaxis, and initial treatment of thromboembolic events.
• To assess outcomes based on different treatment durations and indications.

Main Methods:

• Retrospective analysis of 79 children (2 weeks to 19 years) treated with nadroparin or enoxaparin.
• Categorization of patients into short-term prophylaxis (n=62), long-term prophylaxis (n=13), and initial treatment groups (n=4).
• Review of treatment protocols, dosages (including anti-factor Xa activity), and clinical outcomes.

Main Results:

• No thrombosis occurred in patients receiving short-term LMWH prophylaxis.
• Positive outcomes (no reocclusion, recanalization) observed in children treated with LMWHs after thrombolytic therapy or unfractionated heparin (UFH).
• Minimal side effects (gastrointestinal bleeding, hair loss) reported in two patients, indicating a favorable safety profile.

Conclusions:

• LMWHs demonstrate efficacy and safety in pediatric thromboembolic event prophylaxis and treatment.
• Nadroparin was used without body weight adjustment or anti-FXa monitoring for short-term prophylaxis.
• Long-term prophylaxis and treatment doses were guided by anti-FXa activity, showing good clinical results.