Related Experiment Video
Updated: Aug 6, 2026
06:39
Through-the-Wall Blood Sampling Method to Minimize Sleep Disruption in Clinical Settings
Published on: June 13, 2025
Intermittent Subcutaneous Unfractionated Heparin for Venous Thromboembolism Prophylaxis in Pediatric Intensive Care
Autumn M Spyhalsky1, Kelli Jo Welter1, Mackenzie N DeVine1
1Department of Pharmacy, Children's Hospital Colorado, Aurora, Colorado, USA.
Pediatric Blood & Cancer
|July 23, 2026
Summary
Subcutaneous unfractionated heparin (sUFH) for venous thromboembolism (VTE) prophylaxis in pediatric intensive care units (PICUs) showed bleeding in 24% and VTE in 11% of patients. Standardized dosing and further research are needed for sUFH safety and effectiveness in pediatric VTE prevention.
Area of Science:
- Pediatric critical care medicine
- Pharmacology and therapeutics
- Hematology and thrombosis
Background:
- Venous thromboembolism (VTE) is an increasing complication in pediatric intensive care units (PICUs).
- Intermittent subcutaneous unfractionated heparin (sUFH) is used for VTE prophylaxis in adults but lacks pediatric evidence.
- sUFH offers benefits in specific pediatric patient populations, including those with renal dysfunction or limited IV access.
Purpose of the Study:
- To characterize the prophylactic use of sUFH in a pediatric intensive care unit population.
- To evaluate the incidence of VTE and bleeding events associated with sUFH prophylaxis.
- To inform the development of standardized dosing strategies for pediatric VTE prophylaxis.
Main Methods:
- Retrospective cohort study of pediatric patients (≤ 18 years) receiving sUFH for VTE prophylaxis for ≥ 24 hours.
- Data collection included sUFH dosing, frequency, monitoring, and incidence of bleeding and VTE.
- Analysis compared outcomes between patients with and without VTE and bleeding events.
Main Results:
- Sixty-six pediatric patients received sUFH prophylaxis.
- The median sUFH dose was 89.3 units/kg, with dosing every 8 or 12 hours.
- VTE occurred in 11% of patients, and bleeding occurred in 24% of patients; no significant dose difference was observed between groups.
Conclusions:
- Bleeding events (24%) were more frequent than VTE events (11%) in pediatric patients receiving sUFH prophylaxis.
- Current sUFH dosing strategies may require standardization for improved safety and efficacy in the PICU.
- Further prospective studies are essential to establish optimal sUFH use for VTE prophylaxis in pediatric intensive care.
Related Concept Videos
01:29Venous 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...
01:30Anticoagulant 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...
01:29Drug 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...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:30Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
01:17Pharmacokinetics 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...