Evaluation and Treatment of Neonatal Thrombus Formation in 17 Patients

Abstract

Thrombosis in neonates is a multifactorial disorder. Treatment consisting of r-tPA and an anticoagulant was shown to be a safe and effective approach to clot dissolution in neonates.

Intrauterine Upper Extremity Thrombosis Successfully Treated with Recombinant Tissue Plasminogen Activator, Enoxaparin and Collagenase

“…Anticoagulation and/or fibrinolytic agents are recommended for the treatment of symptomatic thromboemboli [17], a treatment option that has gained importance in recent decades, which have witnessed a significant increase in the number of neonatal cases with thrombosis associated with an increased frequency of diagnostic and therapeutic interventions performed [12]. A review of the literature revealed rt-PA to be the thrombolytic agent of choice.…”

“…Recombinant tissue plasminogen activator (rt-PA) is a thrombolytic agent that has been widely used in adults. Data on the efficacy of this agent in neonates are limited, although in recent years it has been used for the treatment of newborns with extensive arterial thrombosis leading to organ dysfunction [11,12]. …”

Evaluation and treatment of intracardiac thrombus in ten neonates

“…In a recent update, we investigated treatment outcomes in 17 neonates, ten of whom with intracardiac thrombi demonstrated by echocardiography [2]. The mean gestational age of the patients was 28.3 weeks (24-38 weeks); the mean birth weight was 1,433 g (570-4,660 g).…”

“…Working at a busy NICU and dealing with extremely low birth weight infants, we have quite some experience with neonatal intracardiac thrombi. We would like to share with the readers the thrombogenic and acquired risk factors of our patients and their treatment outcomes [1,2].…”

Reply to the correspondence letter by G. Demirel et al.

“…Although recombinant tissue plasminogen activator (r-tPA) has become the agent of choice for thrombolysis, the optimal dosing and duration of treatment are still unknown [7]. Demirel G. and associates [3] report the use of r-tPA in eight neonates with intracardiac thrombosis. r-tPA was used at a dose of 200 μg/kg/h for 6 h infusion in a day for 6 days, and concurrently, enoxaparin was administered subcutaneously at a dose of 1.5 mg/kg twice daily.…”