Yang Lijun, Ye Lifen, Lin Ru
Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart Institute, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China.
Cardiol Young. 2019 Oct;29(10):1307-1309. doi: 10.1017/S1047951119002026. Epub 2019 Sep 2.
We report a neonatal case of the use of alteplase for the lysis of a large aortic arch thrombus formed during extracorporeal membrane oxygenation support. Alteplase (0.1-0.15 mg/kg/hour) was infused for thrombolysis, and meanwhile, unfractionated heparin was administrated at 5-10 U/kg/hour for the anticoagulation purpose. Alteplase was successfully administered to this neonate after the repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation, and the patient survived without apparent catastrophic long-term complications. It is reasonable to consider alteplase therapy during extracorporeal membrane oxygenation support in this setting.
我们报告了1例新生儿病例，该患儿在体外膜肺氧合支持期间形成了巨大的主动脉弓血栓，使用了阿替普酶进行溶栓治疗。以0.1 - 0.15mg/kg/小时的速率输注阿替普酶进行溶栓，同时，为了抗凝目的，以5 - 10U/kg/小时的速率给予普通肝素。该新生儿在体外膜肺氧合支持下进行先天性膈疝修补术后成功接受了阿替普酶治疗，且患者存活，无明显严重的长期并发症。在这种情况下，考虑在体外膜肺氧合支持期间进行阿替普酶治疗是合理的。
