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Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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...
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...
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...
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...

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Related Experiment Video

Updated: May 9, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well
08:01

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

Published on: February 27, 2026

Antithrombin concentrate use in children: a multicenter cohort study.

Trisha E Wong1, Yuan-Shung Huang, Jason Weiser

  • 1Puget Sound Blood Center, Seattle, WA; Division of Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA.

The Journal of Pediatrics
|August 13, 2013
PubMed
Summary

Off-label use of antithrombin concentrate in children has rapidly increased, with 97% of patients receiving it for unapproved indications. This trend is particularly noted in neonates and critically ill children undergoing extracorporeal membrane oxygenation.

Keywords:
CCCCPBCardiopulmonary bypassComplex chronic conditionsECMOExtracorporeal membrane oxygenationFDAFood and Drug AdministrationICD-9-CMInternational Classification of Diseases, 9thRevision, Clinical ModificationPHISPediatric Health Information System

Related Experiment Videos

Last Updated: May 9, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well
08:01

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

Published on: February 27, 2026

Area of Science:

  • Pediatric pharmacology
  • Critical care medicine
  • Hematology

Background:

  • Antithrombin concentrate is approved for specific thrombotic conditions.
  • Its use in pediatric populations, especially off-label, requires further investigation.
  • Tertiary care pediatric hospitals are key settings for complex pediatric cases.

Purpose of the Study:

  • To describe the patterns of off-label antithrombin concentrate use in US pediatric hospitals.
  • To identify patient demographics and clinical characteristics associated with off-label antithrombin concentrate use.
  • To analyze trends in off-label antithrombin concentrate utilization over a decade.

Main Methods:

  • Retrospective, multicenter cohort study.
  • Utilized the Pediatric Health Information System database (2002-2011).
  • Included 4210 admissions of children (<18 years) receiving antithrombin concentrate; off-label use defined by absence of ICD codes for primary hypercoagulable states.

Main Results:

  • Off-label antithrombin concentrate use increased fivefold over the study period.
  • 97% of patients received antithrombin concentrate off-label.
  • Largest age group for use was neonates (45.7%); 87% had complex chronic conditions; extracorporeal membrane oxygenation (43.7%) was the most common associated procedure.

Conclusions:

  • Off-label antithrombin concentrate use is rapidly increasing in critically ill children, especially those on extracorporeal membrane oxygenation.
  • Limited data exist on the safety and efficacy of off-label antithrombin concentrate use.
  • Judicious use and adherence to hospital guidelines are recommended pending further research.