Clinical features and treatment results in preterm infants with intracardiac thrombus

Kara, Mustafa; Güler, Muhlike; Yıldırım, Zühal; Tekgündüz, Kadir Şerafettin; Laloğlu, Fuat; Ceviz, Naci

doi:10.1080/14767058.2019.1647530

Cited by 8 publications

(18 citation statements)

References 30 publications

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“…Thrombolysis was discontinued when the clot was completely lysed or when the physician deemed the therapeutic attempt to be unsuccessful [18]. Recent studies (2001 –2019) used doppler ultrasonography [14–16,28,29] or echocardiography based on thrombosis location [17,20,22,24], while older studies (1986–1988) utilized angiography to monitor thrombus resolution [25,26]. Figure 2 outlines our preferred monitoring plan when using thrombolytic therapy.…”

Section: Resultsmentioning

confidence: 99%

Use of thrombolytic agents to treat neonatal thrombosis in clinical practice

Leong

Patel²,

Samji³

et al. 2022

Blood Coagulation &Amp; Fibrinolysis

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on behalf of the Thrombosis, Hemostasis in Newborns (THiN) Group Among children, neonates have the highest incidence of thrombosis. Thrombolytic agents are used for the management of life and/or organ-threatening thrombosis. Literature on the efficacy and safety of thrombolytic agents in neonates is limited. We reviewed the evidence on dosing, administration, monitoring and treatment duration of tissue plasminogen activator (tPA), streptokinase and urokinase (URK) in neonates (< -28days). A systematic literature search was conducted of current databases from inception until 31 March 2021. The initial search yielded 6881 articles and 18 were retained for review. tPA, streptokinase and URK was utilized in 12, seven and four studies on 115, 51 and 16 patients, respectively. The dose range for tPA, streptokinase and URK was 0.01 -0.6 mg/kg/h, 50-2000 and 1000-0 000 units/kg/h, respectively, and treatment duration ranged from 30 min to 30 days. This is the first study to objectively summarize the efficacy and safety of thrombolytic agents in neonates. Overall, thrombolysis was associated with 87.9% complete or partial thrombus resolution and 7.4% recurrence risk. The bleeding risk associated with thrombolytic agents was 23.1% on pooled analysis, which is higher than other anticoagulants. Larger prospective studies are required to determine effective dosing regimens of these therapeutic drugs and further clarify their efficacy and safety.

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Section: Resultsmentioning

confidence: 99%

Use of thrombolytic agents to treat neonatal thrombosis in clinical practice

Leong

Patel²,

Samji³

et al. 2022

Blood Coagulation &Amp; Fibrinolysis

View full text Add to dashboard Cite

show abstract

“…Bolus dose of rt-TPA was administrated in nine cases with a dosage range of 0.05–1 mg/kg intravenously 14 15 18–21 24. We found that the following continuous infusion of rt-TPA was highly heterogeneous both in terms of dosage (range 0.01–1.2 mg/kg/hour)13 23 and duration (range 1–13 days) 13–15 18 19 21 23. Low-dose rt-TPA was given to 16 of 28 neonates,13–18 20 22 24 while the remaining subjects received high-dose rt-TPA 13 14 18 19 21 23.…”

Section: Commentarymentioning

confidence: 96%

“…Reviewing the literature, 12 studies which reported 28 very or extremely preterm neonates who had pharmacological thrombolysis with rt-TPA for intracardiac thrombi were found13–24 (table 1). Their GA ranged from 23 to 31 weeks14 25 with a birth weight from 544 to 1300 g 13 21. The age at diagnosis of thrombosis was from 1 to 54 days of life 18 20.…”

Section: Commentarymentioning

confidence: 99%

“…We found that the following continuous infusion of rt-TPA was highly heterogeneous both in terms of dosage (range 0.01–1.2 mg/kg/hour)13 23 and duration (range 1–13 days) 13–15 18 19 21 23. Low-dose rt-TPA was given to 16 of 28 neonates,13–18 20 22 24 while the remaining subjects received high-dose rt-TPA 13 14 18 19 21 23. Major complications occurred in four neonates (14%): three developed intraventricular haemorrhage (IVH), whose severity was not detailed, and one pulmonary haemorrhage 13 14 23.…”

Section: Commentarymentioning

confidence: 99%

“…Low-dose rt-TPA was given to 16 of 28 neonates,13–18 20 22 24 while the remaining subjects received high-dose rt-TPA 13 14 18 19 21 23. Major complications occurred in four neonates (14%): three developed intraventricular haemorrhage (IVH), whose severity was not detailed, and one pulmonary haemorrhage 13 14 23. Three of these adverse events occurred in patients treated with high-dose rt-TPA 14 23.…”

Section: Commentarymentioning

confidence: 99%

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