Giglia Therese M, Witmer Char, Procaccini David E, Byrnes Jonathan W
1Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 2Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 3Department of Pediatrics, Pediatric Pharmacy, Johns Hopkins Medical Center, Baltimore, MD. 4Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
Pediatr Crit Care Med. 2016 Mar;17(3 Suppl 1):S77-88. doi: 10.1097/PCC.0000000000000623.
Thrombotic complications are increasingly being recognized as a significant cause of morbidity and mortality in pediatric and congenital heart disease. The objective of this article is to review the medications currently available to prevent and treat such complications.
Online searches were conducted using PubMed.
Studies were selected for inclusion based on their scientific merit and applicability to the pediatric cardiac population.
Pertinent information from each selected study or scientific review was extracted for inclusion.
Four classes of medications were identified as potentially beneficial in this patient group: anticoagulants, antiplatelet agents, thrombolytic agents, and novel oral anticoagulants. Data on each class of medication were synthesized into the follow sections: mechanism of action, pharmacokinetics, dosing, monitoring, reversal, considerations for use, and evidence to support.
Anticoagulants, antiplatelet agents, and thrombolytic agents are routinely used successfully in the pediatric patient with heart disease for the prevention and treatment of a wide range of thrombotic complications. Although the novel oral anticoagulants have been approved for a limited number of indications in adults, studies on the safety and efficacy of these agents in children are pending.
血栓形成并发症日益被认为是小儿及先天性心脏病发病和死亡的重要原因。本文旨在综述目前可用于预防和治疗此类并发症的药物。
使用PubMed进行在线检索。
根据其科学价值及对小儿心脏疾病人群的适用性选择纳入研究。
从每项选定的研究或科学综述中提取相关信息以供纳入。
确定四类药物对此患者群体可能有益：抗凝剂、抗血小板药物、溶栓剂和新型口服抗凝剂。关于每类药物的数据综合在以下各节：作用机制、药代动力学、给药剂量、监测、逆转、使用注意事项及支持证据。
抗凝剂、抗血小板药物和溶栓剂在患有心脏病的小儿患者中常规成功用于预防和治疗多种血栓形成并发症。尽管新型口服抗凝剂已被批准用于成人的有限适应证，但关于这些药物在儿童中的安全性和有效性的研究尚在进行中。
