Am J Perinatol 2021; 38(05): 463-468
DOI: 10.1055/s-0039-1698456
Original Article

Evaluation of the Efficacy of Enoxaparin in the Neonatal Intensive Care Unit

Diane Song
1   Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio
,
Jacqueline Magers
1   Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio
,
Mahmoud Abdel-Rasoul
2   Center for Biostatistics, Ohio State University Medical Center, Biostatistics Resource at Nationwide Children's Hospital, Columbus, Ohio
,
Pavel Prusakov
1   Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio
› Author Affiliations
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Abstract

Objective This article evaluates the efficacy of enoxaparin when targeting anti-factor Xa levels of 0.5 to 1 units per milliliter in the neonatal intensive care unit.

Study Design This is a retrospective chart review of 45 neonates receiving enoxaparin for the treatment of venous thromboembolism. Enoxaparin dosing and corresponding anti-factor Xa levels were collected. Time to resolution of clot was confirmed by imaging and compared between clots in various locations.

Results The median time to clot resolution was 76 days (interquartile range 40–91 days). Clot location, postnatal age, and sex at the clot onset were significantly associated with time to clot resolution in a multivariable Cox model (p-value: 0.03, 0.03, and < 0.01, respectively). Of the 54 patients analyzed for safety, 5 patients (9.3%) experienced bleeding events resulting in the discontinuation of enoxaparin.

Conclusion Based on our findings, 50% of all patients evaluated, regardless of thrombus location, achieved resolution within the first 76 days of therapy. Clots located in the extremities tended to resolve sooner, hence earlier reimaging should be considered.



Publication History

Received: 17 June 2019

Accepted: 03 September 2019

Article published online:
26 October 2019

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