title: Early intracardiac thrombosis in preterm infants and thrombolysis with recombinant tissue type plasminogen activator.
abstract: OBJECTIVE
  To determine the incidence of catheter related thrombosis and to test the efficacy of recombinant tissue type plasminogen activator (rt-PA) in preterm infants.
  
  
  METHODS
  From January 1995 to December 1998, echocardiography was performed in the first few days of life in 76 very low birthweight (< or = 1500 g) infants out of a total of 147 having an umbilical catheter placed. When intracardiac thrombosis was diagnosed, rt-PA infusion was performed.
  
  
  RESULTS
  Four infants (5%) developed an intracardiac thrombosis during the first few days of life. In three of them, rt-PA at a dose of 0.4-0.5 mg/kg in a 20-30 minute bolus led to dissolution of the clot. One patient received a three hour infusion after the bolus, at a dose of 0.1 mg/kg/h, with resolution of the thrombus. No systemic effects were observed after rt-PA infusion.
  
  
  CONCLUSIONS
  Early thrombosis may occur as a complication of umbilical catheterisation in preterm infants; early echocardiographic detection of this disorder allows complete, safe, and rapid lysis with rt-PA.
authors: Department of Paediatrics, Division of Neonatology, Modena University Hospital, Via del Pozzo, 41100 Modena, Italy. Ferrarif@unimo.it
authors: F
authors: F
authors: Ferrari
authors: F
authors: F
authors: Vagnarelli
authors: G
authors: G
authors: Gargano
authors: M F
authors: MF
authors: Roversi
authors: O
authors: O
authors: Biagioni
authors: A
authors: A
authors: Ranzi
authors: G B
authors: GB
authors: Cavazzuti
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015150:Echocardiography, Doppler; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator