Antithrombotic Therapy In Neonates And Children

Publication Date: February 1, 2012
Last Updated: March 14, 2022

Recommendations

Antithrombotic Therapy in Pediatric Patients

We suggest that where possible, pediatric hematologists with experience in TE manage pediatric patients with TE. (2, C)
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When this is not possible, we suggest a combination of a neonatologist/pediatrician and adult hematologist supported by consultation with an experienced pediatric hematologist. (2, C)
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Heparin in Neonates and Children

We suggest that therapeutic UFH in children is titrated to achieve a target range of anti-Xa activity of 0.35 to 0.7 units/mL or an aPTT range that correlates to this anti-Xa range or to a protamine titration range of 0.2 to 0.4 units/mL. (2, C)
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We suggest that when initiating UFH therapy, UFH boluses be no greater than 75 to 100 units/kg and that boluses be withheld or reduced if there are significant bleeding risks. (2, C)
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We suggest avoiding long-term use of therapeutic UFH in children. (2, C)
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Overview

Title

Antithrombotic Therapy In Neonates And Children

Authoring Organization

American College of Chest Physicians