抗凝药在患有功能障碍的儿童:一个叙事审查
Amy L Kiskaddon1,2,3,4,5, Daniel M Witt6, Marisol Betensky2,7
1Division of Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Seminars in thrombosis and hemostasis
|March 28, 2025
概括
在患有脏疾病的儿童中管理抗凝血需要仔细考虑药物的药理动力学,因为脏排泄. 对于许多抗凝血药物的儿科剂量调整存在有限的证据.
科学领域:
- 儿科脏病学 儿科脏病学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 静脉血栓栓塞 (VTE) 是患有病的儿童疾病和死亡的重要原因.
- 有效的VTE治疗和预防需要了解各种抗凝剂.
- 许多抗凝剂通过脏排出,因此需要在功能受损的患者中进行谨慎管理.
研究的目的:
- 在患有功能障碍的儿科患者中审查关键抗凝剂的药理学.
- 为了突出在这个人群中选择,剂量和监测抗凝剂的挑战.
- 为了解决儿科脏剂量调整的有限证据.
主要方法:
- 对患有功能障碍的儿童使用特定抗凝剂的药理学数据的审查.
- 分析影响抗凝剂选择,剂量和监测的因素.
- 对儿科患者对脏剂量调整的现有文献进行了审查.
主要成果:
- 患有功能障碍的儿童的药理动力学变化会影响抗凝剂的有效性和安全性.
- 对于许多抗凝血剂,仅有有限的儿科特异性数据,使剂量调整复杂化.
- 由于功能障碍和出血风险的变化,需要个性化方法.
结论:
- 由于药物动力学变化和数据限制,小儿功能障碍的抗凝管理是复杂的.
- 需要进一步的研究,以建立基于证据的指导方针,用于儿科抗凝剂在脏疾病的剂量.
- 临床医生必须仔细衡量每个孩子的出血风险和功能.
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