• F Ferrari, F Vagnarelli, G Gargano, M F Roversi, O Biagioni, A Ranzi, and G B Cavazzuti.
• Department of Paediatrics, Division of Neonatology, Modena University Hospital, Via del Pozzo, 41100 Modena, Italy. Ferrarif@unimo.it
• Arch. Dis. Child. Fetal Neonatal Ed. 2001 Jul 1;85(1):F66-9.

ObjectivesTo determine the incidence of catheter related thrombosis and to test the efficacy of recombinant tissue type plasminogen activator (rt-PA) in preterm infants.Study DesignFrom January 1995 to December 1998, echocardiography was performed in the first few days of life in 76 very low birthweight (< or = 1500 g) infants out of a total of 147 having an umbilical catheter placed. When intracardiac thrombosis was diagnosed, rt-PA infusion was performed.ResultsFour infants (5%) developed an intracardiac thrombosis during the first few days of life. In three of them, rt-PA at a dose of 0.4-0.5 mg/kg in a 20-30 minute bolus led to dissolution of the clot. One patient received a three hour infusion after the bolus, at a dose of 0.1 mg/kg/h, with resolution of the thrombus. No systemic effects were observed after rt-PA infusion.ConclusionsEarly thrombosis may occur as a complication of umbilical catheterisation in preterm infants; early echocardiographic detection of this disorder allows complete, safe, and rapid lysis with rt-PA.

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