PMID- 37303766
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230701
IS  - 1551-6776 (Print)
IS  - 2331-348X (Electronic)
IS  - 1551-6776 (Linking)
VI  - 28
IP  - 3
DP  - 2023
TI  - Comparison of Time Within Therapeutic Range Using Anti-Factor Xa Versus Activated 
      Partial Thromboplastin Time Monitoring of Unfractionated Heparin in Children.
PG  - 228-234
LID - 10.5863/1551-6776-28.3.228 [doi]
AB  - OBJECTIVE: To compare unfractionated heparin (UFH) monitoring using time in 
      therapeutic range of activated partial thromboplastin time (aPTT) versus 
      anti-factor Xa activity (anti-Xa) in children. METHODS: This retrospective chart 
      review, with data between October 2015 and October 2019, included pediatric 
      patients younger than 18 years on therapeutic UFH infusion with aPTT or anti-Xa 
      monitoring. Patients receiving extracorporeal membrane oxygenation, dialysis, 
      concomitant anticoagulants, prophylactic UFH, no stated goal, and UFH 
      administered for less than 12 hours were excluded. The primary outcome compared 
      the percentage of time in therapeutic range between aPTT and anti-Xa. Secondary 
      outcomes included time to first therapeutic value, UFH infusion rates, mean rate 
      adjustments, and adverse events. RESULTS: A total of 65 patients were included, 
      with 33 aPTT patients and 32 anti-Xa patients, representing 39 UFH orders in each 
      group. Baseline characteristics were similar between groups, with an overall mean 
      age of 1.4 years and mean weight of 6.7 kg. The anti-Xa cohort demonstrated a 
      statistically significantly higher percentage of time in therapeutic range 
      compared with the aPTT group (50.3% vs 26.9%, p = 0.002). The anti-Xa group also 
      demonstrated a trend toward decreased time to first therapeutic value compared 
      with aPTT (14 vs 23.2 hours, p = 0.12). Two patients in each group experienced 
      new or worsening thrombosis. Six patients in the aPTT cohort experienced 
      bleeding. CONCLUSIONS: This study demonstrated greater time was spent within 
      therapeutic range for children receiving UFH monitored with anti-Xa compared with 
      aPTT. Future studies should assess clinical outcomes in a larger population.
CI  - Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, 
      email: membership@pediatricpharmacy.org 2023.
FAU - Haftmann, Richard J
AU  - Haftmann RJ
AD  - Department of Pharmacy Services (RJH, BAH), University of California, Davis 
      Health, Sacramento, CA.
FAU - Pineda, Erika May
AU  - Pineda EM
AD  - Department of Pharmacy Services (EMP), Children's Hospital of Philadelphia, 
      Philadelphia, PA.
FAU - Hall, Brent A
AU  - Hall BA
AD  - Department of Pharmacy Services (RJH, BAH), University of California, Davis 
      Health, Sacramento, CA.
FAU - Wilson, Machelle D
AU  - Wilson MD
AD  - Department of Public Health Sciences (MDW), Division of Biostatistics, Clinical 
      and Translational Science Center, University of California, Davis Health, 
      Sacramento, CA.
FAU - Mateev, Stephanie N
AU  - Mateev SN
AD  - Department of Pediatrics, Division of Pediatric Critical Care (SNM), University 
      of California, Davis Health, Sacramento, CA.
LA  - eng
GR  - UL1 TR001860/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20230602
PL  - United States
TA  - J Pediatr Pharmacol Ther
JT  - The journal of pediatric pharmacology and therapeutics : JPPT : the official 
      journal of PPAG
JID - 101089851
PMC - PMC10249978
OTO - NOTNLM
OT  - anticoagulants
OT  - heparin
OT  - pediatrics
OT  - therapeutic drug monitoring
OT  - thromboembolism
COIS- Disclosures. The authors declare no conflicts or financial interest in any 
      product or service mentioned in the manuscript. The authors had full access to 
      all the data in the study and take responsibility for the integrity of the data 
      and the accuracy of the data analysis. The content is solely the responsibility 
      of the authors and does not necessarily represent the official views of the NIH.
EDAT- 2023/06/12 06:42
MHDA- 2023/06/12 06:43
PMCR- 2023/01/01
CRDT- 2023/06/12 03:57
PHST- 2022/04/13 00:00 [received]
PHST- 2022/07/19 00:00 [accepted]
PHST- 2023/06/12 06:43 [medline]
PHST- 2023/06/12 06:42 [pubmed]
PHST- 2023/06/12 03:57 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.5863/1551-6776-28.3.228 [doi]
PST - ppublish
SO  - J Pediatr Pharmacol Ther. 2023;28(3):228-234. doi: 10.5863/1551-6776-28.3.228. 
      Epub 2023 Jun 2.