Thrombolytic therapy in the management of paediatric thromboembolic disease

Chalmers, Elizabeth; Gibson, Brenda

doi:10.1111/j.1365-2141.1999.01053.x

Cited by 29 publications

(14 citation statements)

References 66 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The only bias is dose adjustment in infants. Because a relatively increased dose is needed in infants to achieve target levels [8,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Çetin¹,

Ekici²,

Ünal

et al. 2014

Pediatric Hematology and Oncology

View full text Add to dashboard Cite

The medical records of 16 patients diagnosed as intracardiac thrombus were searched. The size, location and outcome of thrombus together with demographic data of patients were assessed. The median age of the patients was 2.2 years. Six patients were newborn and two patients were infant. The median size of thrombus was 9 mm. The localization was right atrium in seven, right ventricle in five, left ventricle in one, pulmonary artery in one, and superior vena cava in two patients. There was prematurity in five, ciyanotic congenital heart disease in one, blood culture positivity in three, malignancy in four, nephrotic syndrome in one, indwelling catheters in 10, and acquired or genetic thrombophilia in six patients as risk factors. In the treatment, the first choice was tissue plasminogen activator in two patients, heparin infusion in one patient and low molecular weight heparin in remaining 12 patients. In nine patients, therapy included parenteral antimicrobials together with anticoagulants. The result was complete resolution in 15 patients and in one patient thrombus was surgically removed. The median time was 16 (2-70) days for 50% resolution and 26 (3-93) days for complete resolution. There was a statistically significant (P = .027 and r = 0.5) correlation between the size and the complete resolution time. There was no anticoagulant therapy related major complication. In patients with intracardiac thrombus, selection of anticoagulant therapy may decrease the risk of complications. Surgery is rarely required and thrombolytics are not usually necessary for resolution of thrombus.

show abstract

“…The only bias is dose adjustment in infants. Because a relatively increased dose is needed in infants to achieve target levels [8,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The dosing schedule of thrombolytics and anticoagulants used in these patients is presented in Table 1 [8,9].…”

Section: Methodsmentioning

confidence: 99%

Intracardiac Thrombus in Children: The Fine Equilibrium Between the Risk and the Benefit

Çetin¹,

Ekici²,

Ünal

et al. 2014

Pediatric Hematology and Oncology

View full text Add to dashboard Cite

show abstract

“…Unfractionated heparin therapy was used in 14%, LMWH was used in 5%, and thrombolytic therapy either alone or in combination with unfractionated heparin or LMWH was preferred in 5%. In pediatric patients with thromboembolism, detailed patient management is seriously hampered by the lack of appropriate clinical trials, but until data are available for the treatment of symptomatic children, pediatric patients with thrombosis are mostly treated according to recent recommendations [13,19,20,[31][32][33][34][35]. No conclusion could be drawn in this report about the efficiency of different treatment modalities because of the uncontrolled nature of the registry data.…”

Section: Discussionmentioning

confidence: 93%

Analysis of Pediatric Thrombotic Patients in Turkey

Ören

Devecioğlu

Kemahlı

et al. 2004

Pediatric Hematology and Oncology

View full text Add to dashboard Cite

This study analyzes the data of thrombotic children who were followed up in different pediatric referral centers of Turkey, to obtain more general data on the diagnosis, risk factors, management, and outcome of thrombosis in Turkish children. A simple two-page questionnaire was distributed among contact people from each center to standardize data collection. Thirteen pediatric referral centers responded to the invitation and the total number of cases was 271. All children were diagnosed with thromboembolic disease between January 1995 and October 2001. Median age at time of first thrombotic event was 7.0 years. Of the children 4% of the cases were neonates, 12% were infants less than 1 year old, and 17% were adolescents. Thromboembolic event was mostly located in the cerebral vascular system (32%), deep venous system of the limbs, femoral and iliac veins (24%), portal veins (10%), and intracardiac region (9%). Acquired risk factors were present in 86% of the children. Infection was the most common underlying risk factor. Inherited risk factors were present in 30% of the children. FVL was the most common inherited risk factor. Acquired and inherited risk factors were present simultaneously in 19% of the patients. Eleven children had a history of familial thrombosis. Due to the local treatment preferences, the treatment of the children varied greatly. Outcome of the 142 patients (52%) was reported: 88 (62%) patients had complete resolution, 47 (33%) had complications, 12 (9%) had recurrent thrombosis, and 34 (24%) died. Three children (2.1%) died as a direct consequence of their thromboembolic disease. The significant morbidity and mortality found in this study supports the need for multicentric prospective clinical trials to obtain more generalizable data on management and outcome of thrombosis in Turkish children.

show abstract

“…Thrombosis caused by cardiac catheterization is the most frequent indication for thrombolytic therapy in infants and children (5), but a spectrum of new indications is emerging. The trend in modern childhood thrombotic care is to reduce the dose of thrombolytic Fig.…”

Section: Discussionmentioning

confidence: 99%