Objective. To determine whether warfarin can be safely administered to children who require long-term total parenteral nutrition (TPN), for the purpose of preventing central venous access device (CVAD)-related thrombosis.Methods. A prospective cohort study was conducted of 8 children with short-gut syndrome or small intestinal anomalies. All patients received oral anticoagulant therapy (warfarin) managed by the hematology department at a tertiary pediatric center. Data collected included demographic details, nutritional intake, age, weight, history of deep vein thrombosis, number and functional duration of CVADs, warfarin requirements, and adverse event rates.Results. A total of 15.2 warfarin years were studied prospectively. The target therapeutic range was achieved 51.1% of time. The mean dose of warfarin required to achieve the target therapeutic range (international normalized ratio) of 2.0 to 3.0 was 0.33 mg/kg/d. The mean duration between warfarin monitoring tests was 6.6 days. The median vitamin K intake per patient was 0.367 mg/kg/d (range: 0.018–2.85 mg/kg/d). Before commencing anticoagulant therapy, the mean CVAD duration was 160.9 days. Concomitant warfarin therapy was associated with a mean CVAD duration of 351.7 days. There were no major bleeding events, and no clinical extension of thrombosis was observed.Conclusions. This is the first published study to report uniform warfarin prophylaxis for CVADs in children. Warfarin therapy can be administered safely in children who require long-term TPN. Warfarin prophylaxis seems to prolong CVAD survival
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机译：目的。为了确定华法林是否可以安全地施用于需要长期全胃肠外营养（TPN）的儿童，以预防与中心静脉通路装置（CVAD）相关的血栓形成。对8名患有短肠综合征或小肠异常的儿童进行了一项前瞻性队列研究。所有患者均在三级儿科血液科接受口服抗凝治疗（华法林）。收集的数据包括人口统计学细节，营养摄入，年龄，体重，深静脉血栓形成史，CVAD的数量和功能持续时间，华法林需求量以及不良事件发生率。前瞻性研究了总共15.2华法林年。目标治疗范围达到51.1％的时间。达到2.0至3.0的目标治疗范围（国际标准化比率）所需的华法林平均剂量为0.33 mg / kg / d。华法林监测测试之间的平均持续时间为6.6天。每位患者的维生素K摄入量中位数为0.367 mg / kg / d（范围：0.018–2.85 mg / kg / d）。在开始抗凝治疗之前，平均CVAD持续时间为160.9天。伴随华法林治疗的平均CVAD持续时间为351.7天。没有大的出血事件，也没有观察到血栓形成的临床扩展。这是第一项发表的报告，该报告报告了华法林对儿童CVAD的统一预防作用。需要长期使用TPN的儿童可以安全地使用华法林疗法。华法林预防似乎可以延长CVAD生存
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