In this study, researchers from Australia determined whether warfarin is safe for preventing central venous access device (CVAD)-related thrombosis in children who require long-term total parenteral nutrition (TPN).
The team conducted a prospective cohort study, which included 8 children with short-gut syndrome or small intestinal anomalies. All patients received warfarin.
They recorded demographic details, nutritional intake, age, weight, history of deep vein thrombosis, number and functional duration of CVADs, warfarin requirements, and adverse event rates.
|The target therapeutic range was achieved 51% of time.|
The team prospectively studied a total of 15.2 warfarin years.
The target therapeutic range was achieved 51% of time.
The researchers determined that the mean dose of warfarin required to achieve the target therapeutic range was 0.33 mg/kg/d.
They found that the median vitamin K intake per patient was 0.367 mg/kg/d.
Before commencing anticoagulant therapy, mean CVAD duration was 160.9 days, however, warfarin therapy was associated with a mean CVAD duration of 351.7 days.
The team did not identify any major bleeding events, or clinical extension of thrombosis.
Dr Fiona Newall's team concluded, "This is the first published study to report uniform warfarin prophylaxis for CVADs in children".
"Warfarin therapy can be administered safely in children who require long-term TPN".
"Warfarin prophylaxis seems to prolong CVAD survival".