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High-dose urokinase therapy in newborn infants with major vessel thrombosis
1Division of Neonatology, University of Oklahoma College of Medicine, Tulsa.
Insights
High-dose urokinase effectively treated thrombosis in two newborn infants. Further studies are needed to establish optimal dosing for pediatric thrombosis, especially in neonates.
Area of Science:
- Pediatric Cardiology
- Neonatology
- Hematology
Background:
- Urokinase therapy effectiveness for pediatric thrombosis, particularly in newborns, remains unestablished.
- Neonatal fibrinolytic mechanisms may necessitate higher doses of plasminogen activators.
Abstract:
The effectiveness of urokinase therapy for thrombosis in children, particularly in newborn infants, has not been established. We report our experience with the local administration of high-dose intrathrombus urokinase in two newborn infants. One infant had aortic thrombosis and the other, thrombosis of the right femoral artery. The known abnormalities in the newborn's fibrinolytic mechanism provide the rational basis for the therapeutic use of high doses of plasminogen activators. No significant abnormalities of our patients' fibrinolytic systems were found, and effective thrombolysis was achieved. A literature review of the use of urokinase therapy for thrombosis in children reveals great disparities in dosage and outcome. We believe that fixed-dose regimens should be replaced by individually adjusted thrombolytic therapy and that the need for higher doses of urokinase in newborns should be studied further.