Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Elteren, Hugo A. van; Pas, Arjan B. te; Kollen, Wouter J.W.; Walther, Frans J.; Lopriore, Enrico

doi:10.1159/000316934

Cited by 11 publications

(6 citation statements)

References 17 publications

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“…One extremely low birth weight (ELBW) neonate developed a severe hematoma at the insuflon (small catheter used for daily injections) injection site, which required emergency surgical drainage. We reported this in a recent case report [9]. Another ELBW neonate developed a large abscess at the insuflon injection site, which required surgical drainage.…”

Section: Resultsmentioning

confidence: 91%

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Management and Outcome in 32 Neonates with Thrombotic Events

Elteren

Veldt

Pas

et al. 2011

International Journal of Pediatrics

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Objective. To determine the incidence, management, complications, and outcome in neonates with thrombotic events. Study Design. We performed a retrospective study of all neonates with thrombotic events admitted to our neonatal intensive care unit from January 2004 to July 2010. Results. Thrombotic events were identified in 32 of 4734 neonates (0.7%). Seven neonates were managed expectantly and 25 neonates received anticoagulant treatment. Complete resolution of the clot within 3 months of age was found in 68% (17/25) of the treated and in 86% (6/7) of the nontreated neonates. Major complications due to anticoagulant therapy occurred in 3/25 cases (12%) and included severe hemorrhage (n = 2) and abscess at the injection site (n = 1). Conclusion. Complete or partial clot resolution in neonatal thrombosis occurred in both the treated group and nontreated group. Randomized controlled trials are warranted to determine the optimal management in neonatal thrombosis.

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Section: Resultsmentioning

confidence: 91%

“…However, although serious adverse effects associated with anticoagulant treatment are reported to be rare, several major complications have recently been described [7–9]. Data on the safety and efficacy of LMWH in neonates, and in particular in extremely low birth weight (ELBW) neonates, is scarce and based on a handful of case series.…”

Section: Introductionmentioning

confidence: 99%

Management and Outcome in 32 Neonates with Thrombotic Events

Elteren

Veldt

Pas

et al. 2011

International Journal of Pediatrics

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“…Nitroglycerine is a nitric oxide donor that may have a direct effect on vascular smooth muscle producing local vasodilatation of veins and arteries. [93][94][95] Resultant increased blood flow, due to this acute dilatation, may overcome the vasospasm, allowing flow around microthrombi or improving collateral circulation to the affected areas. 96,97 Anticoagulation Low-molecular-weight heparins (LMWHs) are the most commonly used anticoagulants in infants and children, with enoxaparin being the most frequently used.…”

Section: Management Of Thrombosismentioning

confidence: 99%

“…Although adverse effects from LMWH are rare, several major complications have been described. [93][94][95]116 Enoxaparin must be withheld for 24-h before any invasive procedure. LMWH may be administered either by subcutaneous injection or through an indwelling subcutaneous catheter (Insuflon;Unomedical, Birkerod, Denmark).…”

Section: Low-molecular-weight Heparinmentioning

confidence: 99%

Thrombosis in the Neonatal Intensive Care Unit

Saxonhouse

2015

Clinics in Perinatology

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“…Data on the use of other LMWH in neonates, such as dalteparin and tinzaparin, are still limited. Complications from LMWH therapy include soreness from the injection itself, bruising and, rarely, bleeding (5 %) [29,30].…”

Section: Epidemiology Of Renal Vascular Thrombosismentioning

confidence: 99%

Renal vascular thrombosis in the newborn

Resontoc

Yap

2015

Pediatr Nephrol

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Neonatal renal vascular thrombosis is rare but has devastating sequelae. The renal vein is more commonly affected than the renal artery. Most neonates with renal vein thrombosis present with at least one of the three cardinal signs, namely, abdominal mass, macroscopic hematuria and thrombocytopenia, while unilateral renal artery thrombosis presents with transient hypertension. Contrast angiography is the gold standard for diagnosis but because of exposure to radiation and contrast agents, Doppler ultrasound scan is widely used instead. Baseline laboratory tests for platelet count, prothrombin time, activated partial thromboplastin time and fibrinogen concentration are essential before therapy is initiated. Maternal blood is tested for lupus anticoagulant and anticardiolipin antibody. Evaluation for prothrombotic disorders is warranted when thrombosis is clinically significant, recurrent or spontaneous. Management should involve a multidisciplinary team that includes neonatologists, radiologists, pediatric hematologists and nephrologists. In addition to supportive therapy, recent guidelines recommend at least prophylactic heparin therapy in the majority of cases to prevent thrombus extension. Thrombolytic therapy is reserved for bilateral thrombosis compromising kidney function. Long-term sequelae, such as kidney atrophy, systemic hypertension and chronic kidney disease, are common, and follow-up by pediatric nephrologists is recommended for monitoring of kidney function, early detection and management of hypertension and chronic kidney disease.

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Severe Hemorrhage after Low-Molecular-Weight Heparin Treatment in a Preterm Neonate

Cited by 11 publications

References 17 publications

Management and Outcome in 32 Neonates with Thrombotic Events

Management and Outcome in 32 Neonates with Thrombotic Events

Thrombosis in the Neonatal Intensive Care Unit

Renal vascular thrombosis in the newborn

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