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HEPRIN TREATMENT IN CHILDHOOD AND ITS EFFECT ON MONITORING TESTS
Author(s) -
EKERT H.,
SESHADRI R.
Publication year - 1973
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.1973.tb02233.x
Subject(s) - medicine , heparin , partial thromboplastin time , disseminated intravascular coagulation , peritoneal dialysis , thrombosis , dialysis , purpura fulminans , surgery , anticoagulant , anesthesia , coagulation
SYNOPSIS In childhood, heparin is used for the treatment of disseminated intravascular coagulation (DIC) and in the haemolytic uraemic syndrome (HUS) rather than for thromboembolic disease. Experience in the use of continuous infusions of heparin and its effects on monitoring tests such as the partial thromboplastin time (PTT) are described in this paper. In 9 patients with HUS an average initial dose of 750 units/kg/day of heparin was required to prolong the PTT to 11/2‐21/2 times normal. During peritoneal dialysis, maintenance doses of 600‐680 unit/kg were required. It was necessary to decrease the maintenance dose of heparin to 450‐500 units/kg/day when peritoneal dialysis was discontinued. In 8 patients with DIC an average initial dose of 710 units/kg/day was required to shorten the prolonged PTT. The PTT remained within normal limits despite doses of 500‐600 units/kg/day and was prolonged by increasing the dose to 710 units. One patient with purpura fulminans presented features of DIC and‘hypercoagulability’; heparin in doses of 1600‐4000 units/kg/day was required to prevent recurrence of thrombosis. The dose of heparin and its effect on monitoring tests is determined by the underlying disease process. In DIC the effect of heparin differs from that seen in HUS and in thromboembolic disease.