Manejo de hemorragia pulmonar con eptacog alfa, ácido aminocaproico o ácido tranexámico en neonatos bajo cuidados intensivos
Journal
Revista Mexicana de Pediatría
ISSN
0035-0052
Publisher
Mediagraphic
Date Issued
2025
Author(s)
Solís-Sánchez, Katy Abigail
Rendón-Macías, Mario Enrique
Miranda-Madrazo, María Raquel
Villa-Bahena, Saúl
Ramírez-Silva, Horacio
Díaz-Caneja Arenas, Regina
Type
text::journal::journal article
Abstract
La hemorragia pulmonar (HP) en recién nacidos (RN) es una complicación grave que puede causar la muerte. Objetivo: analizar el efecto del tratamiento con antihemorrágicos (ácido tranexámico [AT], eptacog alfa [EA] o ácido aminocaproico [AA]) en RN con HP, atendidos en una Unidad de Cuidados Intensivos Neonatales. Material y métodos: estudio de una cohorte retrospectiva de 43 neonatos con HP atendidos entre los años 2020 y 2024. Todos recibieron alguno de los tres fármacos (solos o en combinación), además del tratamiento convencional. El éxito del tratamiento se evaluó con la supervivencia, control del sangrado, requerimiento de hemocomponentes y en la recuperación de niveles de hemoglobina y plaquetas. Resultados: se evaluaron 43 RN, 86% pretérmino. En 35 (81%) pacientes se administró un sólo fármaco (AT: n = 8, EA: n = 19, AA: n = 8) y en ocho (18.6%) dos fármacos. Fallecieron nueve pacientes, por lo que la supervivencia fue del 79%. Posterior al inicio de los fármacos, en todos se redujo el requerimiento de transfusiones, pero al final del seguimiento ocho (18.6%) pacientes tenían anemia y cinco (11.6%) trombocitopenia. No hubo diferencia por tipo de fármaco Conclusión: al parecer, el uso de fármacos antihemorrágicos en RN con HP tiene un efecto benéfico; sin embargo, se requiere de más investigación para determinar su eficacia y seguridad, particularmente para conocer las diferencias entre EA, AT o AA. ©Los autores © Revista Mexicana de Pediatría © Graphimedic ©Mediagraphic.
Pulmonary hemorrhage (PH) in newborns is a serious complication that can cause death. Objective: to evaluate the impact of antihemorrhagic therapy—tranexamic acid (TA), eptacog alfa (EA), or aminocaproic acid (AA)—on newborns diagnosed with PH and treated in a Neonatal Intensive Care Unit. Material and methods: a retrospective cohort study was conducted involving 43 newborns diagnosed with PH between 2020 and 2024. All patients received one or more of the three antihemorrhagic agents, in addition to standard supportive care. Treatment outcomes were assessed based on survival, bleeding control, transfusion requirements, and recovery of hemoglobin and platelet levels. Results: of the 43 newborns included, 86% were preterm. A single antihemorrhagic agent was administered to 35 patients (TA: n = 8; EA: n = 19; AA: n = 8), while eight patients (18.6%) received a combination of two drugs. The overall survival rate was 79%, with nine deaths observed. Following initiation of antihemorrhagic therapy, transfusion requirements decreased across all cases. However, by the end of follow-up, eight patients (18.6%) remained anemic and five (11.6%) had thrombocytopenia. No differences in outcomes were observed among the three drugs used. Conclusion: antihemorrhagic therapy may offer clinical benefits in the management of PH in newborns. Nevertheless, further studies are needed to establish the efficacy and safety of these agents, particularly to clarify potential differences between EA, TA, and AA ©Los autores © Revista Mexicana de Pediatría © Graphimedic ©Mediagraphic.
Pulmonary hemorrhage (PH) in newborns is a serious complication that can cause death. Objective: to evaluate the impact of antihemorrhagic therapy—tranexamic acid (TA), eptacog alfa (EA), or aminocaproic acid (AA)—on newborns diagnosed with PH and treated in a Neonatal Intensive Care Unit. Material and methods: a retrospective cohort study was conducted involving 43 newborns diagnosed with PH between 2020 and 2024. All patients received one or more of the three antihemorrhagic agents, in addition to standard supportive care. Treatment outcomes were assessed based on survival, bleeding control, transfusion requirements, and recovery of hemoglobin and platelet levels. Results: of the 43 newborns included, 86% were preterm. A single antihemorrhagic agent was administered to 35 patients (TA: n = 8; EA: n = 19; AA: n = 8), while eight patients (18.6%) received a combination of two drugs. The overall survival rate was 79%, with nine deaths observed. Following initiation of antihemorrhagic therapy, transfusion requirements decreased across all cases. However, by the end of follow-up, eight patients (18.6%) remained anemic and five (11.6%) had thrombocytopenia. No differences in outcomes were observed among the three drugs used. Conclusion: antihemorrhagic therapy may offer clinical benefits in the management of PH in newborns. Nevertheless, further studies are needed to establish the efficacy and safety of these agents, particularly to clarify potential differences between EA, TA, and AA ©Los autores © Revista Mexicana de Pediatría © Graphimedic ©Mediagraphic.
License
Acceso Abierto
How to cite
Solís-Sánchez KA, Miranda-Madrazo MR, Rendón-Macías ME, Villa-Bahena S, Ramírez-Silva H, Díaz-Caneja Arenas R. Manejo de hemorragia pulmonar con eptacog alfa, ácido aminocaproico o ácido tranexámico en neonatos bajo cuidados intensivos. Rev Mex Pediatr. 2025; 92(2): 52-57. https://dx.doi.org/10.35366/121149