The use of alteplase to restore patency of central venous lines in pediatric patients: A cohort study

We evaluated the efficacy and safety of alteplase to restore central venous line (CVL) patency in a consecutive cohort study. A uniform, weight-depend ent protocol for alteplase administration was established prospectively. Fo r children less than or equal to 10 kg, a dose of 0.5 mg was used; for chil dren >10 kg, doses of 1 to 2 mg were used. The alteplase remained instilled for 1 to 4 hours or overnight. Retrospective data accrual found that 25 ch ildren received alteplase for a total of 34 courses; 29 (85%) of the 34 cou rses of alteplase completely restored CVL patency. Alteplase appears to be a safe and effective thrombolytic agent for CVL patency restoration in chil dren.