Departments of Pharmacy.
Mayo Clinic, Rochester, MN.
J Pediatr Hematol Oncol. 2021 Oct 1;43(7):e946-e950. doi: 10.1097/MPH.0000000000002066.
Enoxaparin is commonly used to treat pediatric thrombosis. Several small retrospective studies have suggested that infants and young children require higher enoxaparin doses to achieve therapeutic anti-factor Xa levels compared with adults.
This is a retrospective study of hospitalized children who received enoxaparin for the treatment of thrombosis at a free-standing children's hospital. The primary objective was to ascertain the enoxaparin dose required to achieve an anti-factor Xa level of 0.5 to 1.0 U/mL among 4 age groups in a large cohort of infants and young children between 60 days and 5 years of age.
A total of 176 infants and children were evaluated. The majority of patients were less than 1 year of age (n=104). An inverse relationship between enoxaparin dose needed to achieve therapeutic anti-factor Xa levels and patient age was noted, particularly in the first year of life. Patients who were 60 days to less than 7 months at the time of enoxaparin initiation (n=73) required the highest mean dose among the age groups at 1.73 mg/kg subcutaneously every 12 hours (P<0.0001).
Infants and young children require higher doses of enoxaparin to achieve therapeutic anti-factor Xa levels compared with adults.
依诺肝素通常用于治疗小儿血栓症。几项小型回顾性研究表明，与成年人相比，婴儿和幼儿需要更高的依诺肝素剂量才能达到治疗性抗 Xa 因子水平。
这是一项回顾性研究，在一家独立的儿童医院中，对接受依诺肝素治疗血栓症的住院患儿进行了研究。主要目的是在 60 天至 5 岁大的婴儿和幼儿的大队列中，确定 4 个年龄组达到 0.5 至 1.0 U/mL 的抗 Xa 因子水平所需的依诺肝素剂量。
共评估了 176 名婴儿和儿童。大多数患者年龄小于 1 岁（n=104）。研究观察到达到治疗性抗 Xa 因子水平所需的依诺肝素剂量与患者年龄之间存在反比关系，特别是在生命的第一年。在开始使用依诺肝素时年龄为 60 天至不足 7 个月的患者（n=73），在所有年龄组中需要的平均剂量最高，为皮下注射 1.73 mg/kg，每 12 小时 1 次（P<0.0001）。
与成年人相比，婴儿和幼儿需要更高剂量的依诺肝素才能达到治疗性抗 Xa 因子水平。
