Catheter-Related Venous Thrombosis in Hospitalized Pediatric Patients with Inflammatory Bowel Disease: Incidence, Characteristics, and Role of Anticoagulant Thromboprophylaxis with Enoxaparin

Diamond, Carrie; Hennessey, Carole; Meldau, Jennifer; Guelcher, Christine; Guerrera, Michael F.; Conklin, Laurie S.; Sharma, Karun; Diab, Yaser

doi:10.1016/j.jpeds.2018.02.039

Cited by 20 publications

(17 citation statements)

References 47 publications

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“…Thrombosis is a disease involving multiple factors and systems and a major contributor to global health burden [23]. Many approaches, such as changes in the diameter of catheter [24], tuning of catheter-to-vein ratio [25], novel catheter surface coatings [26], use of catheter-locking solutions [27] or anticoagulants [28], and handgrip exercise [29], have been investigated to prevent CRT. Numerous reports on CRT were clinical studies.…”

Section: Discussionmentioning

confidence: 99%

Role of miR-92a-3p, oxidative stress, and p38MAPK/NF-κB pathway in rats with central venous catheter related thrombosis

Gan

Zhao

Yan

et al. 2020

BMC Cardiovasc Disord

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Background: miR-92a-3p and oxidative stress are reportedly associated with venous thrombosis. However, the role of miR-92a-3p and oxidative stress in catheter-related thrombosis (CRT) remains ambiguous. Herein, we studied the roles of miR-92a-3p, oxidative stress, and p38-mitogen-activated protein kinase/nuclear factor kappa-B (MAPK/NF-κB) pathway in CRT. Methods: Forty-five male rats were randomly and equally divided into control, sham operation, and CRT groups. The rats were sacrificed after 10 days. Reactive oxygen species (ROS), superoxide dismutase (SOD), and malondialdehyde (MDA) levels in the serum were determined by enzyme-linked immunosorbent assay (ELISA). The expression levels of miR-92a-3p, heme oxygenase-1 (HO-1), NF-κB p65, and p38 MAPK in the venous tissues were detected with quantitative polymerase chain reaction (qPCR) and Western blot. Results: Thrombosis was observed only in the CRT group. Compared with the levels in the control and sham operation groups, ROS and MDA significantly increased in the CRT group, but SOD significantly decreased. qPCR and Western blot results showed that miR-92a-3p, HO-1, p38 MAPK, and NF-κB p65 expression was significantly upregulated in the venous tissues of the CRT group. Moreover, miR-92a-3p was positively correlated with HO-1, which was positively correlated with p38 MAPK and NF-κB p65. Conclusion: miR-92a-3p was correlated with oxidative stress in CRT. miR-92a-3p and oxidative stress contributed to endothelial dysfunction and simultaneously was associated with CRT.

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Section: Discussionmentioning

confidence: 99%

Role of miR-92a-3p, oxidative stress, and p38MAPK/NF-κB pathway in rats with central venous catheter related thrombosis

Gan

Zhao

Yan

et al. 2020

BMC Cardiovasc Disord

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“…Some studies, carried out in pediatric population, concluded that thromboprophylaxis is safe and well tolerated with a bleeding rate of 1–5% (24, 25). In previous studies (1, 26, 27), patients with venous sinus thrombosis who received heparin did not have more bleeding episodes or worsening, compared with the placebo group, while mortality was also lower in the treatment group (28–30). Finally, a systematic review and meta-analysis of the literature, with more than 2,000 pediatric patients included, suggested that thromboprophylaxis in pediatric age is safe and effective (31).…”

Section: Discussionmentioning

confidence: 81%

Central Venous Sinus Thrombosis in a Boy With Acute Severe Ulcerative Colitis

et al. 2019

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Cerebral venous sinus thrombosis (CVST) in childhood is uncommon. Certain diseases predispose patients to CVST, such as inflammatory bowel disease (IBD), which is considered a risk factor for developing thrombosis, which in turn is considered an extraintestinal manifestation of IBD. The use of prophylaxis in certain patients is a controversial topic. We present the case of a 5-years-old child with ulcerative colitis, who presented with transverse sinus thrombosis immediately after colectomy. Considering the recent recommendations on prophylaxis in this disease, our patient and probably many others would benefit from establishing treatment with low-molecular-weight heparin. We believe that these recommendations should be known, with our case serving as an example, given that we are heading in a direction that has so far been controversial.

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“…Our results are also strengthened by our use of a nationally representative data set for pediatric hospitalizations, thereby providing more generalizable conclusions than previously published single-center studies. 17,21 An additional novel aspect of our study is the use of a composite outcome of either thrombus or infection associated with PN use. We believe this composite outcome serves as a clinically useful outcome to aid in clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

Thrombotic and Infectious Risks of Parenteral Nutrition in Hospitalized Pediatric Inflammatory Bowel Disease

Egberg

Galanko²,

Barnes

et al. 2018

Inflammatory Bowel Diseases

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Background: Malnutrition is common in inflammatory bowel disease (IBD), requiring timely and sufficient nutritional supplementation. In patients hospitalized for active disease, symptoms and/or altered intestinal function hinder enteral nutrition feasibility. In this scenario, parenteral nutrition (PN) is used. We aimed (1) to assess the frequency of PN use between 1997 and 2012 among hospitalized pediatric patients with IBD, (2) to determine the risk of in-hospital thrombus and infection associated with PN, and (3) to identify predictors of thrombus and infection in pediatric IBD hospitalizations utilizing PN. Methods: We performed a cross-sectional analysis of pediatric patients hospitalized between 1997 and 2012. We used the Kids' Inpatient Database (KID) to identify pediatric patients (≤18 years of age) with Crohn's disease (CD) or ulcerative colitis (UC), PN exposure, and primary outcomes including thrombus and infection. We used multivariable regression to identify risk factors for outcomes of interest. Results: Parenteral nutrition was utilized in 3732 (12%) of 30,914 IBD hospitalizations. Three percent of PN patients experienced a thrombotic complication, and 5.5% experienced an infectious complication. Multivariate analysis showed PN as an independent risk factor for thrombus (odds ratio [OR], 4.3; 95% confidence interval [CI], 3.2-5.6) and infection (OR, 3.8; 95% CI, 3.1-4.6). Surgery was an independent risk factor for thrombus (OR, 2.0; 95% CI, 1.4-2.7) and infection (OR, 2.5; 95% CI, 2.0-3.1) in hospitalizations exposed to PN. Conclusions: Hospitalized pediatric IBD patients, particularly surgical, receiving PN are at increased risk for thrombosis and infection. Clinicians must balance these risks with the benefits of PN.

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Catheter-Related Venous Thrombosis in Hospitalized Pediatric Patients with Inflammatory Bowel Disease: Incidence, Characteristics, and Role of Anticoagulant Thromboprophylaxis with Enoxaparin

Cited by 20 publications

References 47 publications

Role of miR-92a-3p, oxidative stress, and p38MAPK/NF-κB pathway in rats with central venous catheter related thrombosis

Role of miR-92a-3p, oxidative stress, and p38MAPK/NF-κB pathway in rats with central venous catheter related thrombosis

Central Venous Sinus Thrombosis in a Boy With Acute Severe Ulcerative Colitis

Thrombotic and Infectious Risks of Parenteral Nutrition in Hospitalized Pediatric Inflammatory Bowel Disease

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