Related Experiment Video

Updated: Jun 29, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Experience with intravenous enoxaparin in critically ill infants and children

Shelley E Crary1, Heidi Van Orden, Janna M Journeycake

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA. shelley.crary@utsouthwestern.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|October 8, 2008
PubMed

Insights

Intravenous enoxaparin (IV enoxaparin) shows different anti-Factor Xa levels compared to subcutaneous dosing in pediatric intensive care patients. Further research is needed to optimize IV enoxaparin use in children.

Area of Science:

  • Pediatric critical care medicine
  • Pharmacology
  • Pharmacokinetics

Background:

  • Subcutaneous enoxaparin administration is challenging in special pediatric populations like premature infants and edematous children.
  • Intravenous enoxaparin is sometimes used, but pharmacodynamic data for dosing and monitoring are limited.

Purpose of the Study:

  • To evaluate the use and pharmacodynamics of intravenous enoxaparin in pediatric intensive care unit (PICU) patients.
  • To provide initial data on dosing and anti-Factor Xa levels for IV enoxaparin in this population.

Main Methods:

  • Retrospective review of medical records from a single institution's PICU.
  • Identified pediatric patients who received intravenous enoxaparin between April 2005 and March 2006.

Main Results:

  • Seven patients received IV enoxaparin.
  • Anti-Factor Xa levels peaked earlier (1-2 hours) and declined faster with IV than subcutaneous administration.
  • Mean therapeutic doses were 2.40 mg/kg/dose for children <1 year and 1.11 mg/kg/dose for children ≥1 year.

Conclusions:

  • The pharmacodynamics of intravenous enoxaparin differ significantly from subcutaneous administration in pediatric ICU patients.
  • Further investigation is warranted to establish optimal dosing and monitoring strategies for IV enoxaparin in children.
Abstract

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...