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Ting J, Yeung K, Paes B, et al. How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice. Blood Coagul Fibrinolysis. 2021;32(8):531-538doi: 10.1097/MBC.0000000000001052.
Ting, J., Yeung, K., Paes, B., Chan, A. K. C., Petropoulos, J. A., Banfield, L., Bhatt, M. D. (2021). How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 32(8), 531-538. https://doi.org/10.1097/MBC.0000000000001052
Ting, James, et al. "How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice." Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis vol. 32,8 (2021): 531-538. doi: https://doi.org/10.1097/MBC.0000000000001052
Ting J, Yeung K, Paes B, Chan AKC, Petropoulos JA, Banfield L, Bhatt MD. How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice. Blood Coagul Fibrinolysis. 2021 Dec 01;32(8):531-538. doi: 10.1097/MBC.0000000000001052. PMID: 34102656.
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Blood Coagul Fibrinolysis. 2021 Dec 01;32(8):531-538. doi: 10.1097/MBC.0000000000001052.

How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice.

Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis

James Ting, Klement Yeung, Bosco Paes, Anthony K C Chan, Jo-Anne Petropoulos, Laura Banfield, Mihir D Bhatt,

Affiliations

  1. National University of Ireland, Galway, Ireland.
  2. Internal Medicine Residency Program, McMaster University.
  3. Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University.
  4. Division of Pediatric Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, McMaster University.
  5. Health Sciences Library, McMaster University, Hamilton, Ontario, Canada.

PMID: 34102656 DOI: 10.1097/MBC.0000000000001052

Abstract

Among children, neonates have the highest incidence of thrombosis due to risk factors such as catheter instrumentation, an evolving coagulation system and congenital heart disease. Low-molecular-weight heparins (LMWHs) are the most commonly used anticoagulants in neonates. Published guidelines delineate dosing and monitoring protocols for LMWH therapy in newborns. However, challenging clinical situations frequently present that warrant healthcare providers to think critically beyond the range of guidelines, and judiciously resolve specific problems. This review describes the use of LMWH in the neonatal population, including practical aspects such as route and site of administration, preparation from concentrated formulations and methods to minimize pain of subcutaneous injection. It is followed by a discussion on dosing, monitoring and outcomes of LMWH therapy in neonates. The risk of recurrence of thrombosis in neonates after LMWH therapy is approximately 3% based on a pooled analysis of studies reporting this outcome over the last 24 years. The article concludes with an overview of the side-effects of LMWH, including the risk of bleeding which is around 4% based on pooled analyses of more than 30 studies.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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