Thromboprophylaxis In ICU
The incidence of venous thrombosis is likely underappreciated in critically ill children. All children with at least one organ failure and central venous access likely require pharmacological prophylaxis against venous thrombo-embolism. Drug Dose Comments Low molecular weight heparin (LMWH), e.g. enoxaparin. < 2 months of age: 0.75 mg/kg/dose, SC, 12 hourly. > 2 months of age: 0.5 mg/kg/dos
The incidence of venous thrombosis is likely underappreciated in critically ill children. All children with at least one organ failure and central venous access likely require pharmacological prophylaxis against venous thrombo-embolism.
| Drug | Dose | Comments |
| Low molecular weight heparin (LMWH), e.g. enoxaparin. | < 2 months of age: 0.75 mg/kg/dose, SC, 12 hourly. > 2 months of age: 0.5 mg/kg/dose, SC, 12 hourly. |
Avoid with renal insufficiency. Monitoring: 0.2–0.4 anti-Xa U/mL (sample must be drawn in a nonheparinised syringe, 3–4 hours post dose). |
| Unfractionated heparin (UFH). | 10 units/kg/hour, IV, as a continuous infusion. | Not for routine use. Can be used in children with renal insufficiency, those requiring surgery or if they have a high risk of bleeding. |
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 23: Paediatric Intensive Care, 23.9 Venous Thrombo-embolism (VTE), 23.9.1 Thromboprophylaxis In ICU