Pediatr Neonatol
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Case Reports
Successful treatment of arterial thrombus in an extremely low-birth-weight preterm neonate.
Arterial thromboembolism in the pediatric population frequently occurs secondary to arterial catheterization. Catheterization-related complications are more common in smaller and sicker infants, due to high prothrombotic activity, low levels of natural anticoagulants, and various fibrinolytic imbalances. Arterial thrombus management in neonates remains controversial. ⋯ Heparin was stopped, and recombinant tissue plasminogen activator therapy enabled complete recovery from the thrombus. The risk of bleeding (including intracranial hemorrhage) with recombinant tissue plasminogen activator treatment, especially in small preterm neonates is unknown. However, in this extremely low-birth-weight preterm infant, recombinant tissue plasminogen activator therapy was effective, and limiting the infusion rate to ≤0.4 mg/kg/hour was safe.
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Long QT syndrome is a congenital disorder accompanied by a high incidence of sudden cardiac death. β-adrenergic blockade is the therapy of choice, and it is successful in 75-80% of patients. However, for those in whom refractory arrhythmia or cardiac events are not prevented by medication, the literature suggests that left cardiac sympathetic denervation may be useful. Here we present a girl 20 months of age with refractory ventricular tachycardia due to long QT syndrome successfully treated by left cardiac sympathetic denervation. There was no significant complication.
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To determine the optimal timing of surgery for recurrent intussusception. ⋯ The probability of recurrence was 100% after the fourth episode of intussusception in our study. After the third episode of intussusception, the probability of recurrence and eventual surgery were 68% and 70%, respectively. From this study, surgical intervention should be considered at the third episode of intussusception.