Low-dose danaparoid sodium catheter flushes in an intensive care infant suffering from heparin-induced thrombocytopenia

Ranze, Oliver; Rakow, A.; Ranze, Petra; Eichler, Petra; Greinacher, Andreas; Fusch, Christoph

doi:10.1097/00130478-200104000-00013

Cited by 20 publications

(10 citation statements)

References 13 publications

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“…Neonates and young children after cardiac surgery seem to be at the highest risk for HIT. 6 Balancing the benefits against the risks associated with heparin addition to parenteral fluids, we will no longer use heparin in parenteral fluids to maintain patency of peripheral catheters in neonates. For more than 50 years, pain has been recognized as the clinical hallmark of sickle cell disease.…”

Section: Discussionmentioning

confidence: 99%

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Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

Klenner

Fusch

Rakow

et al. 2003

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

“…6,7 HIT occurs between day 5 and 10 of heparin therapy. 8 Clinically active HIT is characterized by a decrease in platelet count by >50%, new thromboembolic complications, or both.…”

mentioning

confidence: 99%

Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

Klenner

Fusch

Rakow

et al. 2003

The Journal of Pediatrics

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“…Because danaparoid does not cross the placenta, it is preferred for parenteral anticoagulation of pregnant patients with HIT (44–46). The other adjunctive treatments include surgical thrombectomy, intravenous gammaglobulin, plasmapheresis (47–49) and antiplatelet agents.…”

Section: Treatmentmentioning

confidence: 99%

Heparin-induced thrombocytopenia (an overview)

Daneschvar

Daw

2006

International Journal of Clinical Practice

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Heparin induced thrombocytopenia is a serious side effect of a drug that is widely used in clinical practice. All patients exposed to heparin, administered by any route or at any dose, are at varying risk of developing HIT and its potentially devastating thrombotic complications. There are two clinical forms of HIT, type I and type II. Type I HIT, is a non-immunologic response, while type II HIT is an immunologic response to heparin therapy. Type I HIT is not associated with an increased risk of thrombosis and is characterized by reversible thrombocytopenia. Type II HIT occurs in approximately 1 to 3% of patients receiving unfractionated heparin. Type II HIT is more severe because of the increased risk of thrombotic events. Venous and arterial thromboembolic complications may lead to amputation, stroke, myocardial infarction, and death.

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“…Thirty-four detailed unique case reports of danaparoid use in children have been traced: 4 unpublished cases from the CUP (cases 19, 20, 21 and 22), 1 patient from the same program (case 26), but published separately [14], 3 previously unpublished cases of the authors (cases 3, 23 and 24), 1 in an MD thesis (case 17) [15] and 25 from 15 independent publications [12,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. Detailed data on these patients, presenting features, treatment and outcome are shown in table 1 and summarized in table 2.…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Danaparoid (Orgaran<sup>®</sup>) Use in Children

Bidlingmaier

Magnani²,

Girisch

et al. 2006

Acta Haematol

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Immune-mediated heparin-induced thrombocytopenia (HIT) is an uncommon but serious complication of therapy with heparins. It affects all ages and requires replacement of the causative anticoagulant. However, information on alternative antithrombotic use in children with HIT is limited. This paper reviews 27 published and 7 unpublished case reports of children aged 2 weeks to 17 years treated with danaparoid. Thirty-three suffered from HIT or suspected HIT, and 1 child without HIT had a high bleeding risk. All children had severe underlying problems increasing their thrombotic and/or bleeding risk. HIT diagnosis was confirmed serologically or clinically in 26 cases (78.8%). Danaparoid regimens were similar to those used in adults, but in general, younger children needed higher daily doses of danaparoid to achieve the same target plasma anti-Xa levels than teenagers or adults. Of those with a known outcome 28/33 children (84.8%) survived, 7 having suffered from a serious adverse event. Five deaths occurred including 1 thrombotic and 2 major bleeds. Three of the in total 4 major bleeding events occurred in children undergoing surgery with cardiopulmonary bypass. We conclude that despite the reported adverse events danaparoid can be used as an alternative antithrombotic for children who are intolerant of the heparins, except in cases requiring cardiopulmonary bypass surgery.

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Low-dose danaparoid sodium catheter flushes in an intensive care infant suffering from heparin-induced thrombocytopenia

Cited by 20 publications

References 13 publications

Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

Heparin-induced thrombocytopenia (an overview)

Safety and Efficacy of Danaparoid (Orgaran<sup>®</sup>) Use in Children

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