Semin Thromb Hemost 1997; 23(3): 303-319
DOI: 10.1055/s-2007-996103
Copyright © 1997 by Thieme Medical Publishers, Inc.

Heparin Therapy in Pediatric Patients

Anton H. Sutor, Patricia Massicotte, Michael Leaker, Maureen Andrew
  • From the Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, Canada.
Further Information

Publication History

Publication Date:
08 February 2008 (online)

Abstract

Advances in tertiary care pediatrics have resulted in heparin being one of the most frequently prescribed drugs in children's hospitals. Heparin is essential for cardiopulmonary bypass, extracorporeal membrane oxygenation, renal dialyses, maintenance of patency of venous and arterial catheters, and treatment of thromboembolic events. Currently, protocols validated in adults are used for children. However, optimal use of heparin in pediatric patients will likely differ from adults because of agedependent physiologic and pathologic differences in hemostasis that influence the activities of heparin.

The following review summarizes the influence of age on heparin anticoagulant activities, and pharmacokinetics. The indications, monitoring, therapeutic range, factors influencing dose-response relationships, and side effects of heparin therapy in pediatric patients are discussed. Finally the current and future indications for low-molecular-weight heparins in pediatric patients are summarized. Multicentered, international clinical trials are urgently needed to assess and optimize the use of heparin in pediatric patients in a variety of clinical settings. Until these studies are completed, recommendations for adults provide guidelines for children.