PMID- 19714446
OWN - NLM
STAT- MEDLINE
DCOM- 20100813
LR  - 20211020
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 29
IP  - 4
DP  - 2010 May
TI  - Monitoring unfractionated heparin in pediatric patients with congenital heart 
      disease having cardiac catheterization or cardiac surgery.
PG  - 429-36
LID - 10.1007/s11239-009-0391-6 [doi]
AB  - Determine the effect of age and congenital heart disease (CHD) on whole blood 
      tests for monitoring unfractionated heparin (UFH) in children. Determine 
      correlation with anti-Xa levels in children undergoing cardiac catheterization or 
      cardiac surgery. A prospective cross-sectional study of 211 healthy children 
      about to have minor surgery (median age 3.5 years) and 110 CHD patients (median 
      age 2.1 years) undergoing cardiac catheterization or cardiac surgery. Commonly 
      used whole blood tests (two activated clotting times and an activated partial 
      thromboplastin time; ACT+, ACT-LR, and APTT, respectively) were obtained before 
      procedures and after UFH in CHD patients. Data were analyzed for effect of age 
      and CHD and correlation with anti-Xa levels. In healthy subjects the ACT+ was 
      lower in younger (<3 years) patients while the ACT-LR and APTT were unaffected. 
      CHD patients exhibited an opposite trend with higher values in the younger 
      patients. After bolus heparin the ACT+ exhibited the strongest correlation (r = 
      0.89) with anti-Xa levels in both locations (the APTT was too sensitive at 
      post-bolus levels). When anti-Xa levels were below 1.0 IU/ml (range of 
      thromboembolism therapy 0.35-0.7 IU/ml), the APTT correlation coefficient was 
      0.72. Some whole blood coagulation tests are affected by age in healthy children 
      similar to laboratory tests and are variably influenced by the presence of CHD. 
      ACT+ is the most reliable predictor of anti-Xa levels in both catheterization and 
      surgery for pediatric patients. The APTT exhibited stronger correlation with 
      anti-Xa than previous reports of laboratory APTT and warrants further evaluation 
      for monitoring heparin thromboembolism therapy.
FAU - Kim, G G
AU  - Kim GG
AD  - Department of Anesthesiology and Critical Care, The Children's Hospital of 
      Philadelphia, Philadelphia, PA 19104, USA.
FAU - El Rouby, S
AU  - El Rouby S
FAU - Thompson, J
AU  - Thompson J
FAU - Gupta, A
AU  - Gupta A
FAU - Williams, J
AU  - Williams J
FAU - Jobes, D R
AU  - Jobes DR
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Anticoagulants)
RN  - 0 (Blood Coagulation Factor Inhibitors)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Anticoagulants/administration & dosage/*pharmacokinetics
MH  - Blood Coagulation Factor Inhibitors/blood
MH  - *Cardiac Catheterization
MH  - Cardiac Surgical Procedures
MH  - Child
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - Factor Xa Inhibitors
MH  - Female
MH  - Heart Defects, Congenital/blood/*therapy
MH  - Heparin/administration & dosage/*pharmacokinetics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - *Monitoring, Physiologic
MH  - Partial Thromboplastin Time
MH  - Prospective Studies
MH  - Thromboembolism/blood/drug therapy
EDAT- 2009/08/29 09:00
MHDA- 2010/08/14 06:00
CRDT- 2009/08/29 09:00
PHST- 2009/08/29 09:00 [entrez]
PHST- 2009/08/29 09:00 [pubmed]
PHST- 2010/08/14 06:00 [medline]
AID - 10.1007/s11239-009-0391-6 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2010 May;29(4):429-36. doi: 10.1007/s11239-009-0391-6.