Accuracy of Doppler echocardiography for the diagnosis of thrombosis associated with umbilical venous catheters

Roy, Madan; Turner-Gomes, Sophronia O.; Gill, Gerald; Way, Clifton; Mernagh, John R.; Schmidt, Barbara

doi:10.1067/mpd.2002.119591

Cited by 62 publications

(43 citation statements)

References 10 publications

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“…Of these, over half resolved without any specific treatment (Kim et al, 2001). However, in some cases UVC-related thrombi result in portal hypertension with consequent splenomegaly and oesophageal varices (Vos et al, 1974;Obladen et al, 1975;Roy et al, 2002). Umbilical artery catheter (UAC)-related events can lead to lower limb ischaemia, hypertension, renal impairment, congestive cardiac failure and distal embolisation.…”

Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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SummaryThe number of children receiving anticoagulation is increasing. Thromboembolic events are associated with significant risk of morbidity and mortality although the optimal management of asymptomatic events remains unclear. Specific challenges in paediatrics include the diagnosis of thrombosis, delivery and monitoring of anticoagulation in a wide range of ages from neonates through to adolescents. The development of the haemostatic system as children age results in changing pathophysiology of thrombosis and response to anticoagulation agents. Although registry and observational studies have provided vital information, specific paediatric, prospective anticoagulation studies have been few and limited in design. The result is that much of current practice is extrapolated from adult studies. Traditional anticoagulants have significant limitations. Both heparin and warfarin are in widespread use but many fundamental questions regarding dose, therapeutic range, efficacy and optimum duration have not been fully answered. Alternative agents, such as direct thrombin inhibitors and the selective anti-factor Xa inhibitor fondaparinux, may have advantages for children. Clinical trials in adults and preliminary data in children are promising but caution should be applied until specific paediatric studies have demonstrated safety and efficacy.

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Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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“…Thrombi generally occur in the hepatic system, ductus venosus, inside the right atrium, and inside the superior or inferior vena cava (15)(16)(17)(18)(19). In our study, thrombus was found in the region where the left hepatic vein drains into the vena cava inferior in only one patient.…”

Section: Discussionmentioning

confidence: 57%

Comparison of methods and formulas used in umbilical venous catheter placement

Mutlu¹,

Pariltan²,

Aslan³

et al. 2017

Turk Pediatri Ars

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Aim: Central venous access is frequently provided by way of umbilical venous catheter placement in critically ill newborns. This study compared the methods of Dunn, Shukla-Ferrara, and Revised Shukla-Ferrara in determining the appropriate insertion length of umbilical vein catheters. Material and Methods:This prospective observational study was carried out in 121 newborns with umbilical venous catheter, group 1 (n=41) used Dunn method, group 2 (n=40) used the Shukla-Ferrara formula, and group 3 used revised Shukla-Ferrara formula (n=40). Catheter tip position was evaluated with an anterior-posterior chest radiograph after insertion of the umbilical venous catheter. The ideal position for the umbilical venous catheter was defined as the catheter tip being visible between the 9 th and 10 th thoracic vertebrae on an anterior-posterior chest radiograph. The position of the umbilical venous catheter was considered too high if the tip of the catheter was higher than the 9 th thoracic vertebra and too low if the tip was below the 10 th thoracic vertebra. The following data were collected: appropriate, inappropriate (low, high) placement, and complications of umbilical venous catheterization. Results:In the Shukla-Ferrara group, 53% (17/32) of umbilical venous catheters were placed directly in the appropriate position, compared with 40% (12/30) in the revised Shukla-Ferrara group and 38% (11/29) in the Dunn method group. Umbilical venous catheter-related complications developed in two patients, thrombus in one, and catheter-related blood stream infection in the other. Conclusions:This study showed that the Shukla-Ferrara formula is more accurate in predicting the insertion length for umbilical venous catheters, though statistical significance was not found. Further studies with larger samples are needed on this topic. (Turk Pediatri Ars 2017; 52: 35-42)

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“…169,215 More specifically, in symptomatic and asymptomatic neonates and children with CHD, a prospective cohort study demonstrated an incidence of thrombosis of 25% resulting from CVL placement, 216 which is similar to other non-CHD pediatric populations. 217,218 The safety and efficacy of prophylaxis in children to prevent CVL-associated thromboembolic events have not been established. The PROTEKT trial, 214 although underpowered, did not find a benefit for the use of prophylactic LMWH.…”

Section: Venous Thrombosis In Chd Including Thrombus Associated With mentioning

confidence: 99%