Anticoagulation in Pediatric Patients

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Techniques in Vascular and Interventional Radiology Pub Date : 2024-06-01 DOI:10.1016/j.tvir.2024.100958

Marilyn J. Manco-Johnson MD , Aparna Annam DO , Timothy Schardt PharmD

{"title":"Anticoagulation in Pediatric Patients","authors":"Marilyn J. Manco-Johnson MD , Aparna Annam DO , Timothy Schardt PharmD","doi":"10.1016/j.tvir.2024.100958","DOIUrl":null,"url":null,"abstract":"<div><p>The use of antithrombotic agents is increasing in infants, children and adolescents. The more recent routine inclusion of children in FDA-monitored clinical trials has propelled the rapid accumulation of safety and efficacy data on these agents in pediatric patients. Antithrombotic agents in current use include indirect or antithrombin-dependent anticoagulants, intravenous direct thrombin inhibitors, direct oral anticoagulants (DOACs) targeting thrombin or factor Xa, antiplatelet agents and thrombolytic therapies. Each class of antithrombotic agent has distinct mechanisms of action, clearance routes, half-lives, safety and dosing. Anticoagulant efficacy is dependent upon the specific clinical indication and stability of the pediatric patient. Duration of anticoagulant course is also dependent upon the clinical indication as well as rate of thrombus resolution. This manuscript reviews the mechanism of action, route of administration, route of clearance and plasma half-life for the antithrombotic agents in current use in children. Use of anticoagulation in the context of thrombolytic therapy is discussed.</p></div>","PeriodicalId":51613,"journal":{"name":"Techniques in Vascular and Interventional Radiology","volume":"27 2","pages":"Article 100958"},"PeriodicalIF":1.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Vascular and Interventional Radiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1089251624000143","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

The use of antithrombotic agents is increasing in infants, children and adolescents. The more recent routine inclusion of children in FDA-monitored clinical trials has propelled the rapid accumulation of safety and efficacy data on these agents in pediatric patients. Antithrombotic agents in current use include indirect or antithrombin-dependent anticoagulants, intravenous direct thrombin inhibitors, direct oral anticoagulants (DOACs) targeting thrombin or factor Xa, antiplatelet agents and thrombolytic therapies. Each class of antithrombotic agent has distinct mechanisms of action, clearance routes, half-lives, safety and dosing. Anticoagulant efficacy is dependent upon the specific clinical indication and stability of the pediatric patient. Duration of anticoagulant course is also dependent upon the clinical indication as well as rate of thrombus resolution. This manuscript reviews the mechanism of action, route of administration, route of clearance and plasma half-life for the antithrombotic agents in current use in children. Use of anticoagulation in the context of thrombolytic therapy is discussed.

查看原文本刊更多论文

儿科患者的抗凝治疗

抗血栓药物在婴儿、儿童和青少年中的使用越来越多。最近，美国食品及药物管理局（FDA）监控的临床试验开始常规纳入儿童，这推动了这些药物在儿童患者中安全性和有效性数据的快速积累。目前使用的抗血栓药物包括间接或抗凝血酶依赖型抗凝剂、静脉注射直接凝血酶抑制剂、针对凝血酶或 Xa 因子的直接口服抗凝剂 (DOAC)、抗血小板药物和溶栓疗法。每一类抗血栓药物都有不同的作用机制、清除途径、半衰期、安全性和剂量。抗凝剂的疗效取决于特定的临床适应症和儿科患者的稳定性。抗凝疗程的持续时间也取决于临床适应症和血栓清除率。本手稿回顾了目前用于儿童的抗血栓药物的作用机制、给药途径、清除途径和血浆半衰期。还讨论了在溶栓治疗中使用抗凝剂的问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.