From Patti Richardson, St. Christopher’s Hospital for Children:
Good afternoon, George: For critical values, are pediatric hospitals using the prothrombin time and international normalized ratio (PT & INR)? For pediatric hospitals, what is the INR critical value most often used?
Hello, Patti, thank you for an excellent question. The Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, published in the February 2012 Supplement to Chest indicate that the adult target INR, 2–3, and INR critical value, 4, may be applied to children, defined as less than 18 years old. The guidelines recommend unfractionated or low molecular weigh heparin for infants, and weight-based Coumadin doses for children other than infants to achieve the target INR when long-term therapy is necessary. I hope this helps.