Anticoagulation With Bivalirudin in Infants and Children
Anticoagulation With Bivalirudin in Infants and Children
Bivalirudin should not be used in patients with a known hypersensitivity to any of its components. It should be used with caution in patients at risk for bleeding. Treatment is contraindicated in patients with significant bleeding.
In adults, the rate of major bleeding with bivalirudin use during procedures is 2.3–3.7% with a rate of minor bleeding of 13.6%. Thrombocytopenia, defined as a platelet count <100,000/mm, has been reported in 0.3–0.7% of patients. Other adverse effects reported in clinical trials of bivalirudin include nausea (in up to 15% of patients), hypotension (12%), hypertension (6%), bradycardia (5%), vomiting (6%), and injection site pain (8%). While limited experience prevents an accurate assessment of the adverse effect profile of bivalirudin in children, the papers published to date suggest a rate of bleeding or thrombotic events of approximately 8–12%. There have been few reports of major bleeding in children receiving bivalirudin. In the open-label catheterization study, 2 of the 110 patients (1.8%) had major bleeding events.
Precautions and Adverse Effects
Bivalirudin should not be used in patients with a known hypersensitivity to any of its components. It should be used with caution in patients at risk for bleeding. Treatment is contraindicated in patients with significant bleeding.
In adults, the rate of major bleeding with bivalirudin use during procedures is 2.3–3.7% with a rate of minor bleeding of 13.6%. Thrombocytopenia, defined as a platelet count <100,000/mm, has been reported in 0.3–0.7% of patients. Other adverse effects reported in clinical trials of bivalirudin include nausea (in up to 15% of patients), hypotension (12%), hypertension (6%), bradycardia (5%), vomiting (6%), and injection site pain (8%). While limited experience prevents an accurate assessment of the adverse effect profile of bivalirudin in children, the papers published to date suggest a rate of bleeding or thrombotic events of approximately 8–12%. There have been few reports of major bleeding in children receiving bivalirudin. In the open-label catheterization study, 2 of the 110 patients (1.8%) had major bleeding events.