UFH Bolus Administration in Comparison to subcutaneous Low Molecular Weight ieparin in pediatric cardiac Catheterization

摘要

Venous or arterial thrombosis after cardiac catheterization is one of the most frequent adverse events. Anticoagulation with heparin reduces this risk of throm-boembolic complications during cardiac catheterization in both children and adults. Different dosages and modalities of heparin administration, from heparin bolus therapy to low-dose flush heparin, have been recommended for the pediatric cardiac catheterization laboratories.Unfractionated heparin (UFH) is still the anticoagulant of choice for the initial treatment of thromboembolic complications as well as for thrombosis prophylaxis in the pediatric patient.Low molecular weight heparin (LMWH) seems to offer a number of advantages over UFH in various clinical settings. In prophylactic trials LMWH were either as effective as UFH or either more effective in preventing thrombotic complications, with no detectable increase of bleeding. The few data available in pediatric patients also suggested that LMWH might be advantageous in this age group. In adults potential advantages of LMWH over UFH in heart catheterization were shown in several clinical trials. By removing the need for coagulation monitoring, LMWH might simplify the procedure while potentially also offering greater efficacy.