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Heparin therapy in pediatric patients
A H Sutor1, P Massicotte, M Leaker
1Hamilton Civic Hospitals Research Centre, Ontario, Canada.
Seminars in Thrombosis and Hemostasis
|January 1, 1997
Summary
Heparin is vital in pediatric care, but adult protocols may not be optimal for children due to age-related differences in hemostasis. Further pediatric-specific trials are needed to refine heparin use in children.
Area of Science:
- Pediatric Pharmacology
- Hematology
- Critical Care Medicine
Background:
- Heparin is frequently used in pediatric tertiary care for various life-support and treatment applications.
- Current pediatric heparin protocols are adapted from adult guidelines, potentially overlooking age-specific physiological differences.
Purpose of the Study:
- To review the impact of age on heparin's anticoagulant activity and pharmacokinetics in pediatric patients.
- To discuss current and future applications of heparin and low-molecular-weight heparins in pediatric medicine.
Main Methods:
- Literature review summarizing age-related influences on heparin.
- Discussion of pediatric indications, monitoring, dosing, and side effects of heparin therapy.
- Summary of low-molecular-weight heparin use in pediatric populations.
Main Results:
- Age-dependent physiological and pathological variations in pediatric hemostasis affect heparin's activity.
- Significant differences exist between adult and pediatric responses to heparin therapy.
- Low-molecular-weight heparins present potential future options for pediatric anticoagulation.
Conclusions:
- Optimal heparin use in pediatric patients requires consideration of age-specific hemostatic differences.
- Further multi-center international clinical trials are essential to establish evidence-based pediatric heparin guidelines.
- Until then, adult recommendations serve as interim guidance for pediatric heparin administration.