Compartment syndrome in an elbw infant receiving low-molecular-weight heparins

Obaid, Laila; Byrne, Paul; Cheung, Po-Yin

doi:10.1016/j.jpeds.2003.09.044

Cited by 29 publications

(21 citation statements)

References 6 publications

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“…In a recent case report with a similar clinical course as described in our patient, Obaid et al [6] described an ELBW neonate with a severe hematoma after treatment with LMWH. The neonate developed rapidly progressive compartment syndrome at the site of enoxaparin administration with an indwelling catheter and necessitated surgical decompression.…”

Section: Color Version Available Onlinesupporting

confidence: 79%

“…Although experience in the pediatric population is increasing, use of LMWH in ELBW neonates is still very limited and few studies have been performed to evaluate safety and dose requirement [3][4][5][6] . Whether the currently used therapeutic range is also applicable to ELBW neonates is not well known.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of recommendations are based on uncontrolled studies, small case series, in vitro experiments or extrapolation of study data performed in the adult and pediatric population [1,2] . Data on the safety and efficacy of LMWH in neonates, and in particular in extremely low birth weight (ELBW) neonates, is scarce and based just on a handful of case series [3][4][5][6] . Although adverse effects are reported to be rare, several major complications have recently been described [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

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Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Elteren¹,

Pas²,

Kollen

et al. 2010

Neonatology

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Thromboembolic events in preterm neonates are increasingly being diagnosed due to the increasing use of umbilical catheters and central venous catheters. Whether thromboembolic events should be treated routinely with low-molecular-weight heparin (LMWH) is controversial and the optimal management is still not clear due to the lack of randomized controlled trials. Most importantly, knowledge about the safety of treatment with LMWH in neonates with thromboembolic events is very limited. We present a case of severe hemorrhage in a preterm neonate after LMWH treatment and summarize the scarce data reported in the literature.

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Section: Color Version Available Onlinesupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Elteren¹,

Pas²,

Kollen

et al. 2010

Neonatology

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“…Local side effects such as bruising, induration and leakage have been described in around 10% of neonates (Malowany et al, 2008). Major local bleeding, including a case of compartment syndrome, has been reported with insuflon use in extremely low birth weight neonates (Dix et al, 2000;Streif et al, 2003;Obaid et al, 2004). Insuflon use for LMWH should be avoided in neonates with minimal subcutaneous tissue.…”

Section: Low Molecular Weight Heparinmentioning

confidence: 99%

Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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SummaryThe number of children receiving anticoagulation is increasing. Thromboembolic events are associated with significant risk of morbidity and mortality although the optimal management of asymptomatic events remains unclear. Specific challenges in paediatrics include the diagnosis of thrombosis, delivery and monitoring of anticoagulation in a wide range of ages from neonates through to adolescents. The development of the haemostatic system as children age results in changing pathophysiology of thrombosis and response to anticoagulation agents. Although registry and observational studies have provided vital information, specific paediatric, prospective anticoagulation studies have been few and limited in design. The result is that much of current practice is extrapolated from adult studies. Traditional anticoagulants have significant limitations. Both heparin and warfarin are in widespread use but many fundamental questions regarding dose, therapeutic range, efficacy and optimum duration have not been fully answered. Alternative agents, such as direct thrombin inhibitors and the selective anti-factor Xa inhibitor fondaparinux, may have advantages for children. Clinical trials in adults and preliminary data in children are promising but caution should be applied until specific paediatric studies have demonstrated safety and efficacy.

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“…Nitroglycerine is a nitric oxide donor that may have a direct effect on vascular smooth muscle producing local vasodilatation of veins and arteries. [93][94][95] Resultant increased blood flow, due to this acute dilatation, may overcome the vasospasm, allowing flow around microthrombi or improving collateral circulation to the affected areas. 96,97 Anticoagulation Low-molecular-weight heparins (LMWHs) are the most commonly used anticoagulants in infants and children, with enoxaparin being the most frequently used.…”

Section: Management Of Thrombosismentioning

confidence: 99%

Thrombosis in the Neonatal Intensive Care Unit

Saxonhouse

2015

Clinics in Perinatology

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Compartment syndrome in an elbw infant receiving low-molecular-weight heparins

Cited by 29 publications

References 6 publications

Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Aspects of anticoagulation in children

Thrombosis in the Neonatal Intensive Care Unit

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