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December 1988

Successful Urokinase Therapy for Superior Vena Cava Syndrome in a Premature Infant

Am J Dis Child. 1988;142(12):1267-1268. doi:10.1001/archpedi.1988.02150120021018

Sir.—Thrombosis and infection are serious complications of central venous catheterization.1 Treatment with thrombolytic agents and antibiotics given through the central catheter has yielded variable results.13 We treated an infant of very low birth weight who developed thrombosis, infection, and superior vena cava (SVC) syndrome as complications of the insertion of a central venous catheter. The infant was successfully treated with a continuous peripheral intravenous infusion of urokinase.

Patient Report.—A 760-g male infant was delivered by cesarean section at 26 weeks' gestation; he had Apgar scores of 2 at 1 minute and 7 at 5 minutes. The immediate neonatal course was complicated by hyaline membrane disease that required endotracheal intubation and assisted ventilation.

At 6 days of age a Broviac catheter (Davol/Bard, Cranston, RI) was inserted via the facial vein into the right internal jugular vein to facilitate venous access and to provide parenteral nutrition. The infant