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Oral anticoagulation therapy in children

Mariana M Bonduel1

  • 1Servicio de Hematolgía y Oncología, Hospital de Pediatría "Prof. Dr. JP Garrahan", Buenos Aires, Argentina. mbonduel@garrahan.com.ar

Thrombosis Research
|May 20, 2006
PubMed

Insights

Oral anticoagulant therapy in children, primarily using warfarin, presents challenges. Infants require dose adjustments and frequent monitoring for effective treatment of thromboembolic complications.

Area of Science:

  • Pediatric Thrombosis and Anticoagulation
  • Pharmacology and Therapeutics

Background:

  • Oral anticoagulant therapy in children is primarily based on adult data.
  • Coumarin derivatives, including warfarin, are the mainstays of treatment for pediatric thromboembolic complications.

Purpose of the Study:

  • To review current practices, challenges, and guidelines for oral anticoagulant therapy in children.
  • To discuss indications, side effects, and reversal of anticoagulation in pediatric patients.

Main Methods:

  • Analysis of prospective studies from Canada and Argentina on warfarin and acenocoumarol administration.
  • Review of existing literature on pediatric anticoagulant therapy and monitoring.

Main Results:

  • Pediatric oral anticoagulant therapy, especially in infants under 12 months, is complex.
  • Infants require higher doses, careful loading dose adjustments, frequent monitoring, and more frequent dose adjustments to maintain therapeutic International Normalized Ratio (INR).
  • Achieving and maintaining the target INR range is more challenging in younger children.

Conclusions:

  • Current guidelines for oral anticoagulants in children highlight significant difficulties in administration and monitoring.
  • Specialized approaches are needed for effective and safe anticoagulation in pediatric patients, particularly infants.
  • Further research is warranted to optimize anticoagulant regimens for children.

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