HIGH-DOSE UROKINASE THERAPY IN NEWBORN-INFANTS WITH MAJOR VESSEL THROMBOSIS

The effectiveness of urokinase therapy for thrombosis in children, par ticularly in newborn infants, has not been established. We report our experience with the local administration of high-dose intrathrombus ur okinase in two newborn infants. One infant had aortic thrombosis and t he other, thrombosis of the right femoral artery. The known abnormalit ies in the newborn's fibrinolytic mechanism provide the rational basis for the therapeutic use of high doses of plasminogen activators. No s ignificant abnormalities of our patients' fibrinolytic systems were fo und, and effective thrombolysis was achieved. A literature review of t he use of urokinase therapy for thrombosis in children reveals great d isparities in dosage and outcome. We believe that fixed-dose regimens should be replaced by individually adjusted thrombolytic therapy and t hat the need for higher doses of urokinase in newborns should be studi ed further.