Tissue Plasminogen Activator Use in Pediatric Patients: A Single Center Experience


PEKPAK E., İNCE E., ERTEM M., Tutar E., Ileri T., UÇAR T., ...Daha Fazla

Journal of Pediatric Hematology/Oncology, cilt.43, sa.5, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 5
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1097/mph.0000000000002031
  • Dergi Adı: Journal of Pediatric Hematology/Oncology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE
  • Anahtar Kelimeler: tissue plasminogen activator, children, thrombosis, CARDIAC-CATHETERIZATION, THROMBOLYTIC THERAPY, CHILDREN, THROMBOSIS, ANTICOAGULATION
  • Ankara Üniversitesi Adresli: Evet

Özet

© 2021 Lippincott Williams and Wilkins. All rights reserved.Introduction: Thrombosis is rare in children and antithrombolytic treatment is controversial. Most commonly used thrombolytic agent is tissue plasminogen activator (t-PA) in pediatrics. In this study, we report our experience in the use of thrombolytic treatment. Methods: Eighteen patients who had received systemic t-PA between January 2006 and December 2013 were recorded. The response to t-PA was evaluated as complete, partial, and no. The bleeding complication during t-PA administration was graded as minor or major. Results: There were 18 patients (2 mo to 12 y) who received systemic t-PA. Three patients had venous, 14 patients had arterial, and 1 patient had intracardiac thrombosis. Thrombosis was related to cardiac catheterization (61.1%), central venous catheterization (16.7%), cardiac surgery (11.1%), and arrhythmia (5.5%). In 1 patient thrombosis occurred spontaneously (5.5%). Eighteen patients received 25 courses of systemic t-PA (0.15 to 0.3 mg/kg/h). A total of 55.6% of cases had complete, 27.8% had partial, and 16.6% showed no resolution. Conclusion: T-PA infusion at doses of median 0.2 mg/kg/h (0.15 to 0.3) seems effective and safe. There is still no consensus on indications and dosing of antithrombolytic treatment in children but in selected patients it decreases long-Term complications due to thrombosis.