Neonatal Thromboembolism

Abstract

In neonates and infants numerous clinical and environmental conditions such as the use of central lines, cardiac diseases and polycythemia, renal diseases such as congenital nephrotic syndrome and neonatal hemolytic uremic syndrome, peripartal asphyxia, infants of diabetic mothers, dehydration, septicemia, necrotizing enterocolitis, acute respiratory distress syndrome, and extracorporeal membrane oxygenation lead to elevated thrombin generation and subsequent thrombus formation. Genetic prothrombotic defects [protein C, protein S and antithrombin deficiency, mutations of coagulation factor V and factor II, elevated lipoprotein (a)] have been established as risk factors for thromboembolic events. The interpretation of laboratory results relies on age-dependent normal reference values. Because appropriate clinical trials are missing in these age groups, treatment recommendations are adapted from small-scale studies in neonates and infants and from guidelines relating to adult patient protocols. Secondary long-term anticoagulation should be administered on an individual basis.

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

“…Case report la colocación de sondas venosas y arteriales, 1 las cardiopatías, 2 la diabetes materna, 3,4 la transferencia de anticuerpos antifosfolípidos, 5 la deshidratación, la septicemia, el síndrome de dificultad respiratoria (SDR), la coagulación intravascular diseminada y la asfixia. 4 Presentamos el caso de una recién nacida con tromboembolia arterial sometida a una amputación después de presentar SDR.…”

Neonatal arterial thromboembolism and limb loss following respiratory distress syndrome. Case report

“…Case report asphyxia. 4 We present a case of a neonate with an arterial thromboembolism who underwent amputation following RDS.…”

Is an increased hematocrit at birth a trigger for UVC‐related thrombosis in preterm very low birth weight neonates?

“…I n the pediatric population, neonates are at greatest risk for thromboembolism with an incidence of about 5.1 per 100,000 live births or 2.4 per 1,000 neonatal care unit admissions [1,2]. Up to 90% of pediatric thromboses are related to central venous catheters with a morbidity of up to 12% and a related mortality of 2% [3].…”

“…However, up to 30% of neonates with a central venous catheter still develop a related thrombosis [4]. Multiple acquired risk factors for neonatal thrombosis have been described including polycythemia with a hematocrit >65%, while the influence of inherited thrombophilia is controversial [1,5].…”

“…. What is the influence of inherited thrombophilia of the infant or of maternal thrombophilic states [1,5]? .…”