Point-of-care monitoring of anticoagulant therapy in paediatric patients

Increased numbers of children with congenital heart disease are requiring anticoagulant therapy, as many of the medical and surgical interventions aimed at curing or palliating cardiac disease are associated with an increased risk of thromboembolic complications. The prospect of managing anticoagulant therapy in children presents several unique challenges. This article provides practical guidance in managing anticoagulant therapy in children through summarizing key principles that assist in managing anticoagulant therapy in children with congenital heart disease. Monitoring requirements of oral anticoagulant and low molecular weight heparin therapy in children are reviewed along with management of associated adverse events, treatment failures, and recommendations for patient education relating to anticoagulation and its influence on outcomes.