在早产新生儿和婴儿中优化治疗性埃诺沙巴林
Madeline Abbott1, Anna Bustin O'Brien1, Kelsie Ellis1
1Department of Pharmacy Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
Thrombosis research
|November 21, 2024
概括
过早出生的新生儿需要每12小时一次通过皮下注射平均2毫克/千克的埃诺沙巴林剂量,才能达到治疗性抗Xa水平. 这一发现有助于优化这种脆弱人群的抗凝剂治疗.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 儿科血栓形成症 儿童血栓形成症
背景情况:
- 埃诺沙巴林是一种低分子量肝素,用于抗凝剂.
- 治疗性抗Xa水平对于有效的埃诺沙巴林治疗至关重要.
- 在早产新生儿和婴儿中服用剂量尚未确立.
研究的目的:
- 确定早产新生儿和婴儿所需的埃诺沙巴林剂量,以达到目标抗Xa水平.
- 为了评估初始的埃诺沙巴林剂量及其疗效.
- 在这个人群中评估血栓事件和出血.
主要方法:
- 对早产婴儿 (<37周妊娠期,<12周产后年龄) 的回顾性图表审查.
- 患者每12小时接受皮下注射埃诺沙巴林,目标抗Xa值为0.5-1单位/毫升.
- 主要终点:素剂量达到治疗性抗Xa水平.
主要成果:
- 需要的中位数埃诺沙巴林剂量为每12小时一次皮下注射2毫克/千克.
- 初始剂量为1.7mg/kg,每12小时一次,通过皮下注射,在41%的患者中达到治疗水平.
- 血栓进展发生在8%,新血栓发生在13%,报告有1例肺出血.
结论:
- 过早出生的新生儿和婴儿需要每12小时进行一次皮下注射,以达到治疗性抗Xa水平,平均需要2毫克/千克的埃诺沙巴林剂量.
- 目前的剂量指南可能需要为这一群体进行调整.
- 对新生儿的最佳埃诺沙巴林剂量进行进一步的研究是有必要的.
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