Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T19:26:30.556Z Has data issue: false hasContentIssue false
  • English
  • Français

The use of alteplase in a newborn with an aortic arch thrombus during extracorporeal membrane oxygenation

Published online by Cambridge University Press:  02 September 2019

Lijun Yang ,
Lifen Ye  and
Ru Lin Open the ORCID record for Ru Lin [Opens in a new window]
Lijun Yang
Affiliation:
Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children’s Hospital, Hangzhou, China
Lifen Ye
Affiliation:
Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children’s Hospital, Hangzhou, China
Ru Lin*
Affiliation:
Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children’s Hospital, Hangzhou, China
*
Author for correspondence: Ru Lin, Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children’s Hospital, 3333 Binsheng Road, Binjiang District, Hangzhou 310052, China. Tel: +86 13857148130; Fax: +86057186029132; E-mail: linru.008@zju.edu.cn
Get access Rights & Permissions [Opens in a new window]

Abstract

We report a neonatal case of the use of alteplase for the lysis of a large aortic arch thrombus formed during extracorporeal membrane oxygenation support. Alteplase (0.1–0.15 mg/kg/hour) was infused for thrombolysis, and meanwhile, unfractionated heparin was administrated at 5–10 U/kg/hour for the anticoagulation purpose. Alteplase was successfully administered to this neonate after the repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation, and the patient survived without apparent catastrophic long-term complications. It is reasonable to consider alteplase therapy during extracorporeal membrane oxygenation support in this setting.

Keywords

Alteplaseneonatalextracorporeal membrane oxygenationthrombus
Type
Brief Report
Information
Cardiology in the Young , Volume 29 , Issue 10 , October 2019 , pp. 1307 - 1309
Check for updates
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Garcia, A, Gander, JW, Gross, ER, et al. The use of recombinant tissue-type plasminogen activator in a newborn with an intracardiac thrombus developed during extracorporeal membrane oxygenation. J Pediatr Surg 2011; 46: 2021–2024.CrossRefGoogle Scholar
Andrew, M, Vegh, P, Johnston, M, Bowker, J, Ofosu, F and Mitchell, L. Maturation of the hemostatic system during childhood. Blood 1992; 80: 1998–2005.CrossRefGoogle ScholarPubMed
Giglia, TM, Witmer, C, Procaccini, DE and Byrnes, JW. Pediatric Cardiac Intensive Care Society 2014 Consensus Statement: pharmacotherapies in cardiac critical care anticoagulation and thrombolysis. Pediatr Crit Care Med 2016; 17: S77–S88.CrossRefGoogle ScholarPubMed
Olarte, JL, Glover, ML and Totapally, BR. The use of alteplase for the resolution of an intravesical clot in a neonate receiving extracorporeal membrane oxygenation. Asaio Journal 2001; 47: 565–568.CrossRefGoogle Scholar