Haematologica, Vol 92, Issue 2, 244-247 doi:10.3324/haematol.10616
Copyright © 2007 by Ferrata Storti Foundation
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Thrombosis

A clinically significant incidence of bleeding in critically ill children receiving therapeutic doses of unfractionated heparin: a prospective cohort study

Stefan Kuhle, Pablo Eulmesekian, Brian Kavanagh, Patricia Massicotte, Patricia Vegh, Lesley G. Mitchell

From the Division of Haematology/Oncology (SK); Departments of Critical Care Medicine & Anesthesia (PE, BK); Department of Population Health Sciences, The Hospital for Sick Children, University of Toronto, Toronto (PV, LGM); Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Canada (SK, PM, LGM)

Correspondence: Lesley Mitchell, Stollery Children’s Hospital, Dept of Pediatrics, Pediatric Thrombosis Program, Dentistry Pharmacy Centre, Rm 1130, 11304-89 Avenue, Edmonton, AB T6G 2C7. E-Mail: LesleyMitchell{at}cha.ab.ca

Unfractionated heparin (UFH) is frequently prescribed for children for the prevention and treatment of thrombosis; however, its safety and efficacy have not been assessed. The aim of this single center, prospective cohort study was to determine the incidence of major bleeding and recurrent thrombosis in children receiving UFH. Major bleeding was defined a priori as: central nervous system or retroperitoneal bleeding, bleeding resulting in UFH being stopped or overt bleeding causing a drop in hemoglobin >20 g/dL in less than 24 h. Major bleeding events occurred in 9/38 children (24%, 95% CI 11–40%) and 2/38 (5%, 95% CI 0–18%) developed thrombosis. In conclusion, there is clinically significant bleeding in children receiving UFH.

Key words: unfractionated heparin, children, bleeding.




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