Anticoagulation therapy in neonates, children and adolescents

Anticoagulation of neonates, children and adolescents remains an important part of clinical care for many individuals. There are different options for anticoagulation, each with their own advantages and disadvantages and selection of an appropriate anticoagulation regime for the specific condition should be judicious. This is in part because age related differences in the coagulation systems exist that mean that the pharmacokinetics and pharmacodynamics of anticoagulation drugs vary across the pediatric spectrum in addition to being distinct from adults. The use of anticoagulant drugs presents specific challenges in the pediatric setting. This review will consider the main anticoagulants currently in use in neonates, children and adolescents, specifically Heparin (unfractionated heparin and low molecular weight heparin) vitamin K antagonist (warfarin) as well as a brief discussion of fondaparinux.