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Related Experiment Videos

Thrombolysis in newborns and infants.

U Nowak-Göttl1, K Auberger, S Halimeh

  • 1Department of Paediatrics, University Children Hospital Münster, Germany. leagottl@uni-muenster.de

Thrombosis and Haemostasis
|March 1, 2000
PubMed
Summary

This review of thrombolytic therapy in infants found streptokinase, urokinase, and rt-PA had similar efficacy rates. While bleeding complications were rare, careful assessment of benefits versus risks is crucial for neonates and infants.

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Area of Science:

  • Pediatric Cardiology
  • Neonatal Medicine
  • Pharmacology

Background:

  • Thrombolytic therapy is crucial for treating vascular occlusions in neonates and infants.
  • Streptokinase (SK), urokinase (UK), and recombinant tissue-type plasminogen activator (rt-PA) are commonly used agents.
  • Limited data exists on the comparative efficacy and safety of these agents in this vulnerable population.

Purpose of the Study:

  • To review and analyze literature reports on the use of SK, UK, and rt-PA for thrombolytic therapy in neonates and infants.
  • To assess the efficacy and safety profiles of these thrombolytic agents.
  • To identify potential differences in outcomes and adverse events.

Main Methods:

  • Literature review of reports from 1970 to 1998.

Related Experiment Videos

  • Analysis of data from 182 infants treated with SK, UK, or rt-PA.
  • Examination of thrombolytic patency rates and reported complications, including bleeding events and pulmonary embolism.

    • Main Results:

    • A total of 182 infants received SK (29.5%), UK (22.5%), or rt-PA (48%).
    • Overall thrombolytic patency rates ranged from 39% to 86%.
    • Bleeding complications (local, pulmonary, gastrointestinal, intraventricular hemorrhage) were rarely reported, with only two thrombolysis-related deaths due to hemorrhage.

    Conclusions:

    • No significant difference in efficacy was observed between SK, UK, and rt-PA in infants (p=0.09).
    • The decision to use thrombolytic therapy requires balancing potential benefits (preventing organ/limb damage) against risks (side effects, costs).
    • Controlled prospective multicenter studies are recommended to further evaluate patency rates and adverse effects of different thrombolytic agents in neonates and infants.