Division of Hematology/Oncology/Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
Department of Paediatrics, University of Melbourne, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne 3052, Victoria, Australia.
Thromb Res. 2020 Mar;187:113-121. doi: 10.1016/j.thromres.2019.12.019. Epub 2019 Dec 31.
The preterm and term neonatal population is most at risk for thrombotic complications in pediatrics. Among various treatment modalities, anticoagulation is primarily used in the management of thrombosis. Developmental differences in preterm and term infants compared to older infants and children and limitations of anticoagulation agents currently used are important considerations for treatment. Additionally, dosages and durations of anticoagulant treatment are widely variable across countries. This article will highlight the differences in anticoagulation in neonates compared to other populations due to developmental hemostatic changes, epidemiology of neonatal thrombosis, pharmacokinetic and pharmacodynamic properties of drugs used and presence of neonatal co-morbidities.
早产儿和足月儿群体在儿科中最容易发生血栓并发症。在各种治疗方式中,抗凝治疗主要用于血栓的管理。与年龄较大的婴儿和儿童相比,早产儿和足月儿在发育上存在差异,以及目前使用的抗凝药物存在局限性,这些都是治疗时需要考虑的重要因素。此外,各国之间的抗凝治疗剂量和持续时间差异很大。本文将重点介绍由于发育性止血变化、新生儿血栓形成的流行病学、所用药物的药代动力学和药效学特性以及新生儿合并症的存在,导致新生儿与其他人群在抗凝方面的差异。