Anticoagulation Monitoring
Program
Children with some kinds of heart problems must take anticoagulation medicines. These
medicines, sometimes called blood thinners, decrease the risk of problems caused by blood
clots. There are several different types of anticoagulation medicines and all of them
reduce the body's ability to make blood clots. The most common reason children need
anticoagulation medicine is because they have an artificial heart valve. Harmful clots can
form on this valve which block the blood flow across the valve or could travel elsewhere
in the body. Children whose blood flow through the heart is slower than normal may also be
placed on an anticoagulation medicine. Finally, some children with heart rhythm problems
need this type of medicine. The two most common medicines used for anticoagulation are
aspirin and Coumadin. Children taking aspirin do not require any special monitoring.
Children who are taking Coumadin must have their blood tested regularly to make sure
that the dose of medication is appropriate. The dose must be high enough to protect the
child from developing harmful clots but not so high that the child is at risk for serious
bleeding. The blood test is called a prothrombin time and measures how much the clotting
system has been affected by the medicine. When a child is first started on Coumadin, the
prothrombin time must be checked once or twice a week. When it is clear that the dose of
Coumadin is safe, the blood test can then be done once a month. Close monitoring of
prothrombin times is very important for children taking Coumadin.
The prothrombin time can be drawn by most health facilities and the results sent to the
Clinic for evaluation and follow-up. You will need to choose the laboratory that you will
be using regularly, and let us know their address and phone number so that we can make the
necessary arrangements with them. At the clinic, the prothrombin time can be done by a
finger poke method. This is helpful for babies or children from whom it may be difficult
to get blood from a vein. Prothrombin times can be affected by other medications or major
dietary changes that the child requires. Whenever your child is started on a new medicine,
goes to the dentist, or requires a surgical procedure, make sure that the doctor knows
that your child is taking Coumadin. |
