Format

Send to

Choose Destination
Rev Chil Pediatr. 2015 May-Jun;86(3):194-9. doi: 10.1016/j.rchipe.2015.03.004. Epub 2015 Jul 30.

[Recombinant tissue plasminogen activator for the management of intracardiac thrombi in newborns].

[Article in Spanish]

Author information

1
Hospital Roberto del Río, Santiago, Chile; Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Clínica Alemana de Santiago, Santiago, Chile. Electronic address: pazenteno@yahoo.com.
2
Hospital Roberto del Río, Santiago, Chile; Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Clínica Santa María, Santiago, Chile.
3
Hospital Roberto del Río, Santiago, Chile.
4
Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Servicio de Neonatología, Hospital San José, Santiago, Chile.
5
Alumno de Medicina, Universidad de Chile, Santiago, Chile.
6
Alumno de Medicina, Universidad Finis Terrae, Santiago, Chile.

Abstract

INTRODUCTION:

The incidence of cardiac thrombi in newborns has increased with the use of central venous catheters. Thrombolysis with recombinant tissue plasminogen activator (rTPA) has been used as an alternative to heparin in life threatening giant thrombus and embolization. The aim of this study is to describe the response and complications related to the use of rTPA in the management of life- threatening cardiac thrombi in newborns.

PATIENTS AND METHOD:

The medical records of 8 newborn were reviewed in a retrospective study, of whom 7 were preterm with cardiac thrombi, and rTPA was used in all of them.

RESULTS:

The patients included 4 males with a mean weight of 1580 gr. The principal pathology was sepsis (7/8), all of them used venous central catheter. The superior vena cava was the most frequent location, with a mean time of installation before the diagnosis of 12 days. RN 7/8 thrombi were located in the right atrium with a size between 7 to 20 mm. Three patients received low molecular weight heparin prior to using rTPA. They received between 1 to 5 cycles with rTPA. In 4 patients complete resolution of the thrombus was achieved in a mean of 3.5 days. Four patients had intracranial haemorrhage grade I, without sequelae at follow-up. There were no deaths or embolism.

CONCLUSION:

This study is the first series of infants treated with rTPA in Chile, and where its use has quickly achieved complete resolution of the thrombus in 50% of cases, and partially in the others, thus reducing the secondary life-threatening risk of this disease.

KEYWORDS:

Activador plasminógeno tisular recombinante; Intracardiac thrombi; Neonatal thrombolysis; Recombinant tissue plasminogen activator; Trombos cardiacos; Trombólisis neonatal

PMID:
26235268
DOI:
10.1016/j.rchipe.2015.03.004
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Scientific Electronic Library Online
Loading ...
Support Center