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Recombinant Tissue Plasminogen Activator (Alteplase) for Restoration of Function to Occluded Central Venous Catheters in Pediatric Patients

2003; Lippincott Williams & Wilkins; Volume: 25; Issue: 1 Linguagem: Inglês

10.1097/00043426-200301000-00009

1536-3678

Violet Shen, Xin Li, Margie A. Murdock, Laura Resnansky, Edward R. McCluskey, Charles P. Semba,

Vascular anomalies and interventions

To evaluate the safety and efficacy of alteplase for restoring function to occluded central venous catheters in a pediatric population.A phase III, open-label, single-arm, multicenter trial was performed in 995 adult and pediatric patients with dysfunctional nondialysis catheters and ports. This report is a subset analysis of subjects between 2 and 18 years of age (N = 122) who were enrolled in the study. Alteplase (2 mg/2 mL) was instilled into the dysfunctional catheter lumen and assessed at 30 and 120 minutes. Subjects weighing > or =30 kg received 2 mL of alteplase; subjects 14 days duration, the efficacy was 91%, 78%, and 60%, respectively. Success was independent of the patient's age, sex, body weight, CVC type, or catheter age. There were no cases of death, ICH, major bleeding episodes, or embolic events attributable to treatment.An alteplase regimen of up to two 2-mg doses is safe and effective for restoration of function to occluded central venous catheters in a pediatric population.