Tromboembolia arterial y amputación de una extremidad en un neonato posterior al síndrome de dificultad respiratoria: Caso clínico

La tromboembolia en los recien nacidos es un problema grave. Los factores de riesgo mas importantes son iatrogenicos, entre ellos, el uso de sondas umbilicales o vias centrales permanentes. Entre otros factores de riesgo, se incluyen la asfixia, la deshidratacion, la septicemia, la cardiopatia, el sindrome de dificultad respiratoria, la coagulacion intravascular diseminada, la trombofilia congenita (deficiencia de proteina C o proteina S), la diabetes mellitus materna y la transferencia pasiva de anticuerpos antifosfolipidos maternos. Los recien nacidos son mas vulnerables que los adultos a presentar una trombosis debido a su menor capacidad fibrinolitica. Describimos el caso de una recien nacida de un dia de vida con tromboembolia arterial en el miembro inferior; sin via central. La tromboembolia en este caso estuvo asociada con un sindrome de dificultad respiratoria. Se realizo trombolisis; tratamiento anticoagulante y trombectomia quirurgica. Posteriormente; se amputo el miembro inferior por debajo de la rodilla. Thromboembolic disease in newborn infants is a serious problem. The most important risk factors are iatrogenic factors, including indwelling umbilical catheters or central catheters. Other risk factors include asphyxia, dehydration, sepsis, cardiac disease, respiratory distress syndrome (RDS), disseminated intravascular coagulation, congenital thrombophilia (i.e., protein C or protein S deficiency), maternal diabetes mellitus, and passive transfer of maternal antiphospholipid antibodies. Neonates are more vulnerable to thrombosis than adults due to their reduced fibrinolytic capability. We describe a case of a 1-day-old female newborn with arterial thromboembolism in the lower leg without a central line catheter. The thromboembolismin in this case was associated with RDS. The infant underwent thrombolysis, anticoagulation therapy, and surgical thrombectomy. The leg of the infant was subsequently amputated below the knee. The case is described here with a brief review of relevant literatures.