A clinical audit of antithrombin concentrate use in a tertiary paediatric centre

Kozul C et al. – This data provides the basis for future investigations of the specific biochemical changes accompanying antithrombin concentrate (ATC) administration and the development of paediatric–specific evidence–based guidelines for ATC use.

Methods

• A clinical audit was performed of patients treated with ATC during two 12-month periods: 1 June 1999–1 June 2000 and 1 June 2009–1 June 2010.

Results

• Thirty-seven patients whose age ranged from 1 day to 13.5 years (median 30 days) received a median of two doses (range 1–15) with a median dose of 40 units/kg (range 1–200 units).
• The majority (90%) of patients were located in the intensive care unit, and the major indication (76%) for use of the ATC was in the setting of unfractionated heparin (UFH) resistance.
• Post-ATC administration, 32% of the doses given resulted in antithrombin levels reaching age-specific normative levels.
• Of the patients administered ATC with the aim of optimising UFH therapy, 28% of patients had their UFH dose reduced without any measurement of UFH effect.

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