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Early intracardiac thrombosis in preterm infants and thrombolysis with recombinant tissue type plasminogen activator

F Ferrari1, F Vagnarelli, G Gargano

  • 1Department of Paediatrics, Division of Neonatology, Modena University Hospital, Via del Pozzo, 41100 Modena, Italy. Ferrarif@unimo.it

Archives of Disease in Childhood. Fetal and Neonatal Edition
|June 23, 2001
PubMed

Insights

Catheter-related thrombosis occurs in 5% of preterm infants. Recombinant tissue plasminogen activator (rt-PA) effectively and safely dissolves these clots, allowing for rapid treatment.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Hematology

Background:

  • Umbilical catheters are essential for preterm infant care.
  • Catheter-related thrombosis is a potential complication.
  • Early detection and treatment are crucial.

Purpose of the Study:

  • To determine the incidence of catheter-related thrombosis in very low birthweight infants.
  • To evaluate the efficacy of recombinant tissue type plasminogen activator (rt-PA) for treating intracardiac thrombosis.
  • To assess the safety of rt-PA in this population.

Main Methods:

  • Echocardiography was performed on 76 very low birthweight infants with umbilical catheters.
  • Intracardiac thrombosis was diagnosed via echocardiography.
  • rt-PA was administered for thrombus lysis.

Main Results:

  • Four infants (5%) developed intracardiac thrombosis.
  • rt-PA successfully dissolved clots in three infants with a bolus dose.
  • One infant required a prolonged infusion after the bolus, achieving resolution.
  • No systemic adverse effects were observed with rt-PA treatment.

Conclusions:

  • Early thrombosis is a complication of umbilical catheterization in preterm infants.
  • Echocardiography enables early diagnosis of catheter-related thrombosis.
  • rt-PA provides a safe and effective treatment for rapid clot lysis.
Abstract

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