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Initial experience of enoxaparine as anticoagulant during mechanical circulatory support in children

^a Department of Anesthesiology and Intensive Care, Helsinki University Hospital, Hospital for Children and Adolescents, P.O. BOX 281, 00029 HUS, Helsinki, Finland
^b Department of Cardiac Surgery, Helsinki University Hospital, Hospital for Children and Adolescents, Helsinki, Finland

*Corresponding author. Tel: +358-9-4717 2725; fax: +358-9-4717 4701.

E-mail address: leena.mildh{at}hus.fi (L. Mildh).

Unfractioned heparin–infusion is traditionally used for anticoagulation during mechanical circulatory support. We evaluated initial experience of subcutaneous enoxaparine during mechanical circulatory support in children. Nine consecutive children treated with Berlin Heart mechanical support were enrolled in this retrospective analysis. Of these, 3/9 were anticoagulated with enoxaparine, 6/9 anticoagulated with unfractioned heparin served as historical controls. Unfractioned heparin-group was divided in two (early/late) according to patients chronological order. All enoxaparine-treated children survived and had no significant bleeding or thromboembolic disorders. Four of the 6 children anticoagulated with unfractioned heparin died. The mean daily substitution of platelets, red blood cells, fresh frozen plasma and anti-thrombin III-concentrate was lower in the enoxaparine group compared to both early and late unfractioned heparin-groups. Enoxaparine as anticoagulant for mechanical circulatory support in children seems promising with significantly less bleeding disorders and blood product consumption.

Key Words: Ventricular assist device (VAD); Pediatric heart failure; Anticoagulation