TY - JOUR T1 - Oral anticoagulation in paediatric patients: dose requirements and complications. JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 228 LP - 231 DO - 10.1136/adc.74.3.228 VL - 74 IS - 3 AU - R C Tait AU - E J Ladusans AU - M El-Metaal AU - R G Patel AU - A M Will Y1 - 1996/03/01 UR - http://adc.bmj.com/content/74/3/228.abstract N2 - The lack of oral anticoagulant guidelines specific to paediatric practice has led to the adoption of adult regimens, often without scientific evidence of efficacy or safety. A two year prospective study of anticoagulant control was carried out in 45 children aged 9 months to 18 years, the majority of whom were receiving primary prophylactic anticoagulation. The main indication was congenital heart disease, either with (n = 8) or without (n = 34) mechanical valve prosthesis. During a follow up period of 602 patient months the average interval between visits was three weeks. Target international normalised ratios (INRs) were achieved on 62% and 39% of visits for children with low target INR (2.0-3.0) and high target INR (3.0-4.0) respectively. However warfarin dose was altered on only 22% of visits. Warfarin doses required to achieve a stable INR of 2.0-3.0 in 33 children were strongly correlated with weight [dose (mg/d) = 0.07 x weight (kg) + 0.54] but independently influenced by age. No thrombotic complications were recorded, and haemorrhagic events were infrequent (2.1% of visits) and, with one exception, minor. Safe outpatient oral anticoagulation is feasible in children, whose warfarin requirements appear moderately predictable and whose control is no more erratic than that of adults. ER -