UROKINASE THERAPY IN NEONATES WITH CATHETER-RELATED CENTRAL VENOUS THROMBOSIS

The results of fibrinolytic therapy with urokinase were evaluated in 2 6 neonates with catheter related central venous thrombosis. Complete t hrombolysis could be achieved in 13 patients (50%), partial thrombolys is in 3 patients (12%). No effect was seen in 10 patients (38%). Thera py success was influenced by age, size and location of the thrombus. C oincidence of infection occurred in 16 patients (62%). Mild hemorrhagi c complications were seen in patients (8%), no other significant side effects were observed. Nine patients with residual thrombosis were tre ated with oral anticoagulants following urokinase resulting in resolut ion of the thrombus in 6 patients within 3 months (67%). The incidence of asymptomatic recurrent thrombosis was high (28%). Urokinase might be an effective and safe treatment for central venous thrombosis in ne onates. Prophylactic antibiotic therapy during the infusion of urokina se and long-term treatment with oral anticoagulants after thrombosis a re advisable. Early detection of thrombosis might enhance the success rate of fibrinolytic therapy. Therefore, we strongly recommend routine echocardiographic screening of central venous catheters.