PMID- 26148660
OWN - NLM
STAT- MEDLINE
DCOM- 20151123
LR  - 20150831
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 167
IP  - 3
DP  - 2015 Sep
TI  - Antithrombin Concentrate Use in Children Receiving Unfractionated Heparin for 
      Acute Thrombosis.
PG  - 645-9
LID - S0022-3476(15)00589-2 [pii]
LID - 10.1016/j.jpeds.2015.06.006 [doi]
AB  - OBJECTIVE: To characterize features of antithrombin concentrate (ATC) use in 
      children receiving unfractionated heparin (UFH) therapy for acute thrombosis. 
      STUDY DESIGN: All pediatric patients at Texas Children's Hospital who received 
      ATC in the context of UFH therapy for acute thrombosis during February 2011 to 
      May 2013 were analyzed. RESULTS: Fifty-one children received ATC during UFH 
      therapy for acute thrombosis. Median age was 3 months (IQR 1 to 18 months). 
      Clinical indications included venous (53%), arterial (37%), venous and arterial 
      (6%), and intracardiac (4%) thrombosis. Median baseline antithrombin (AT) level 
      was 61% and UFH dose was 26 U/kg/h. The median dose of ATC was 49.9 IU/kg (IQR 
      32.6 to 50.0 IU/kg). Although most patients (86%) did not undergo a change in UFH 
      dose, there was a significant increase in both AT and anti-factor Xa level after 
      the first dose of ATC (P < .001 for both). There was no correlation between ATC 
      dose or increment in AT level above baseline and the achievement of targeted 
      anticoagulation by anti-factor X activity level. Adverse bleeding events occurred 
      in 10% of patients. CONCLUSIONS: There was a significant change in AT and 
      anti-factor Xa activity level after a single dose of ATC despite little to no 
      change in dose of UFH. ATC appears to facilitate anticoagulation with UFH in some 
      children with acute thrombosis but the degree of response is variable and 
      dependent on factors identified in this study. Bleeding and other theoretical 
      risks must be carefully considered.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Diaz, Rosa
AU  - Diaz R
AD  - Texas Children's Hospital, Houston, TX. Electronic address: Rxdiaz@txch.org.
FAU - Moffett, Brady S
AU  - Moffett BS
AD  - Texas Children's Hospital, Houston, TX.
FAU - Karabinas, Shaina
AU  - Karabinas S
AD  - Texas Children's Hospital, Houston, TX.
FAU - Guffrey, Danielle
AU  - Guffrey D
AD  - Baylor College of Medicine, Houston, TX.
FAU - Mahoney, Donald H Jr
AU  - Mahoney DH Jr
AD  - Texas Children's Hospital, Houston, TX.
FAU - Yee, Donald L
AU  - Yee DL
AD  - Texas Children's Hospital, Houston, TX.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150703
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Disease
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombin III/*therapeutic use
MH  - Antithrombins/blood
MH  - Dose-Response Relationship, Drug
MH  - Factor Xa Inhibitors/blood
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Partial Thromboplastin Time
MH  - Thrombosis/*drug therapy
EDAT- 2015/07/08 06:00
MHDA- 2015/12/15 06:00
CRDT- 2015/07/08 06:00
PHST- 2015/01/13 00:00 [received]
PHST- 2015/05/07 00:00 [revised]
PHST- 2015/06/03 00:00 [accepted]
PHST- 2015/07/08 06:00 [entrez]
PHST- 2015/07/08 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0022-3476(15)00589-2 [pii]
AID - 10.1016/j.jpeds.2015.06.006 [doi]
PST - ppublish
SO  - J Pediatr. 2015 Sep;167(3):645-9. doi: 10.1016/j.jpeds.2015.06.006. Epub 2015 Jul 
      3.