Recommendations for systemic thrombolysis in neonates and children.
| Contraindications . | |
|---|---|
| Strong | within 10 days after hemorrhage or major surgery |
| within 7 days after severe asphyxia | |
| within 3 days after invasive procedure | |
| Soft | within 48 hours after cerebral convulsion |
| prematurity < 32 weeks of gestation | |
| sepsis | |
| active minor hemorrhage | |
| refractory thrombcytopenia and hypofibrinogenemia | |
| Contraindications . | |
|---|---|
| Strong | within 10 days after hemorrhage or major surgery |
| within 7 days after severe asphyxia | |
| within 3 days after invasive procedure | |
| Soft | within 48 hours after cerebral convulsion |
| prematurity < 32 weeks of gestation | |
| sepsis | |
| active minor hemorrhage | |
| refractory thrombcytopenia and hypofibrinogenemia | |
| Therapy . | Loading Dose . | Maintenance . | Monitoring . |
|---|---|---|---|
| Indications: extensive and/or life/organ-threatening thrombosis. Contraindications: on an individual basis to be considered relative, not absolute; keep fibrinogen > 0.5 g/L and platelets > 50 g/L; increasing D-dimers indicate effective fibrinolysis; dose reduction or cessation of rt-PA if major bleeding occurs; minor bleeding (oozing from catheter puncture site or wound) treat with local pressure; optimal duration of rt-PA therapy uncertain, mostly up to 7 days, shorter/longer courses | |||
| rt-PA | 0.1–0.2 mg/kg/10 min. | 0.8–2.4 mg/kg/24 h | FI, platelets, D-dimers |
| UFH | none | 5–10 U/kg/h | Apt |
| Therapy . | Loading Dose . | Maintenance . | Monitoring . |
|---|---|---|---|
| Indications: extensive and/or life/organ-threatening thrombosis. Contraindications: on an individual basis to be considered relative, not absolute; keep fibrinogen > 0.5 g/L and platelets > 50 g/L; increasing D-dimers indicate effective fibrinolysis; dose reduction or cessation of rt-PA if major bleeding occurs; minor bleeding (oozing from catheter puncture site or wound) treat with local pressure; optimal duration of rt-PA therapy uncertain, mostly up to 7 days, shorter/longer courses | |||
| rt-PA | 0.1–0.2 mg/kg/10 min. | 0.8–2.4 mg/kg/24 h | FI, platelets, D-dimers |
| UFH | none | 5–10 U/kg/h | Apt |