Oral anticoagulation in paediatric patients: dose requirements and complications

Tait, R.C. , Ladusans, E.J., El-Metaal, M., Patel, R.G. and Will, A.M. (1996) Oral anticoagulation in paediatric patients: dose requirements and complications. Archives of Disease in Childhood, 74(3), pp. 228-231. (doi: 10.1136/adc.74.3.228) (PMID:8787428) (PMCID:PMC1511432)

Abstract

The lack of oral anticoagulant guidelines specific to paediatric practice has led to the adoption of adult regimens, often without scientific evidence of efficacy or safety. A two year prospective study of anticoagulant control was carried out in 45 children aged 9 months to 18 years, the majority of whom were receiving primary prophylactic anticoagulation. The main indication was congenital heart disease, either with (n = 8) or without (n = 34) mechanical valve prosthesis. During a follow up period of 602 patient months the average interval between visits was three weeks. Target international normalised ratios (INRs) were achieved on 62% and 39% of visits for children with low target INR (2.0-3.0) and high target INR (3.0-4.0) respectively. However warfarin dose was altered on only 22% of visits. Warfarin doses required to achieve a stable INR of 2.0-3.0 in 33 children were strongly correlated with weight [dose (mg/d) = 0.07 x weight (kg) + 0.54] but independently influenced by age. No thrombotic complications were recorded, and haemorrhagic events were infrequent (2.1% of visits) and, with one exception, minor. Safe outpatient oral anticoagulation is feasible in children, whose warfarin requirements appear moderately predictable and whose control is no more erratic than that of adults.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Tait, Dr Robert
• Authors: Tait, R.C., Ladusans, E.J., El-Metaal, M., Patel, R.G., and Will, A.M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Archives of Disease in Childhood
• Publisher: BMJ Publishing Group
• ISSN: 0003-9888
• ISSN (Online): 1468-2044