Use of thrombolytic agents to treat neonatal thrombosis in clinical practice
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved..
Among children, neonates have the highest incidence of thrombosis. Thrombolytic agents are used for the management of life and/or organ-threatening thrombosis. Literature on the efficacy and safety of thrombolytic agents in neonates is limited. We reviewed the evidence on dosing, administration, monitoring and treatment duration of tissue plasminogen activator (tPA), streptokinase and urokinase (URK) in neonates (≤ 28days). A systematic literature search was conducted of current databases from inception until 31 March 2021. The initial search yielded 6881 articles and 18 were retained for review. tPA, streptokinase and URK was utilized in 12, seven and four studies on 115, 51 and 16 patients, respectively. The dose range for tPA, streptokinase and URK was 0.01 -0.6 mg/kg/h, 50-2000 and 1000-0 000 units/kg/h, respectively, and treatment duration ranged from 30 min to 30 days. This is the first study to objectively summarize the efficacy and safety of thrombolytic agents in neonates. Overall, thrombolysis was associated with 87.9% complete or partial thrombus resolution and 7.4% recurrence risk. The bleeding risk associated with thrombolytic agents was 23.1% on pooled analysis, which is higher than other anticoagulants. Larger prospective studies are required to determine effective dosing regimens of these therapeutic drugs and further clarify their efficacy and safety. Blood Coagul Fibrinolysis 33:000-000 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
|---|---|
| Enthalten in: |
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis - 33(2022), 4 vom: 01. Juni, Seite 193-200 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Leong, Russell [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
EC 3.4.- |
|---|
| Anmerkungen: |
Date Completed 02.06.2022 Date Revised 24.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1097/MBC.0000000000001134 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM338162119 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM338162119 | ||
| 003 | DE-627 | ||
| 005 | 20231226000042.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/MBC.0000000000001134 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1127.xml |
| 035 | |a (DE-627)NLM338162119 | ||
| 035 | |a (NLM)35285449 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Leong, Russell |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Use of thrombolytic agents to treat neonatal thrombosis in clinical practice |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.06.2022 | ||
| 500 | |a Date Revised 24.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a Among children, neonates have the highest incidence of thrombosis. Thrombolytic agents are used for the management of life and/or organ-threatening thrombosis. Literature on the efficacy and safety of thrombolytic agents in neonates is limited. We reviewed the evidence on dosing, administration, monitoring and treatment duration of tissue plasminogen activator (tPA), streptokinase and urokinase (URK) in neonates (≤ 28days). A systematic literature search was conducted of current databases from inception until 31 March 2021. The initial search yielded 6881 articles and 18 were retained for review. tPA, streptokinase and URK was utilized in 12, seven and four studies on 115, 51 and 16 patients, respectively. The dose range for tPA, streptokinase and URK was 0.01 -0.6 mg/kg/h, 50-2000 and 1000-0 000 units/kg/h, respectively, and treatment duration ranged from 30 min to 30 days. This is the first study to objectively summarize the efficacy and safety of thrombolytic agents in neonates. Overall, thrombolysis was associated with 87.9% complete or partial thrombus resolution and 7.4% recurrence risk. The bleeding risk associated with thrombolytic agents was 23.1% on pooled analysis, which is higher than other anticoagulants. Larger prospective studies are required to determine effective dosing regimens of these therapeutic drugs and further clarify their efficacy and safety. Blood Coagul Fibrinolysis 33:000-000 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Streptokinase |2 NLM | |
| 650 | 7 | |a EC 3.4.- |2 NLM | |
| 650 | 7 | |a Tissue Plasminogen Activator |2 NLM | |
| 650 | 7 | |a EC 3.4.21.68 |2 NLM | |
| 650 | 7 | |a Urokinase-Type Plasminogen Activator |2 NLM | |
| 650 | 7 | |a EC 3.4.21.73 |2 NLM | |
| 700 | 1 | |a Patel, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Samji, Nasrin |e verfasserin |4 aut | |
| 700 | 1 | |a Paes, Bosco A |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Anthony K C |e verfasserin |4 aut | |
| 700 | 1 | |a Petropoulos, Jo-Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Bhatt, Mihir D |e verfasserin |4 aut | |
| 700 | 0 | |a Thrombosis, Hemostasis in Newborns (THiN) Group |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis |d 1992 |g 33(2022), 4 vom: 01. Juni, Seite 193-200 |w (DE-627)NLM012606456 |x 1473-5733 |7 nnns |
| 773 | 1 | 8 | |g volume:33 |g year:2022 |g number:4 |g day:01 |g month:06 |g pages:193-200 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/MBC.0000000000001134 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 33 |j 2022 |e 4 |b 01 |c 06 |h 193-200 | ||