Risk factors associated with umbilical vascular catheter‐associated thrombosis in newborn infants

Abstract

Umbilical arterial catheter-associated thrombosis was common. Umbilical arterial catheter should be removed as soon as possible when not needed. Upon removal of UAC, all infants should be screened for abdominal aortic thrombus by 2-D ultrasonography.

Genetic prothrombotic mutations are common in neonates but are not associated with umbilical catheter-associated thrombosis

“…In previous reports, the UVC-associated thrombosis incidence depends on the type of the study and the timing of the study in relation to catheter removal. 4,10,27,32 The incidence of UVC-associated thrombosis in our study was 21.4% and is comparable to previous studies. The majority of clots were in the IVC; all babies were asymptomatic and managed conservatively.…”

“…[2][3][4][5][6]27 UACs have been in use for more than 40 years, with the reported incidence of thrombosis being almost constant, in spite of advances in the types of material used to make UACs. 28 The reported risk factors for thrombosis include the presence of an intravascular catheter, 29 duration of catheterization, 4 infusion of calcium containing fluids 5 and dehydration, sepsis, polycythemia or congenital heart disease. 30 Horgan et al 31 reported that continuous infusion of heparin, which is a standard practice worldwide, will not decrease the risk of thrombosis, but will prolong the patency of the catheter.…”

“…1 Thrombosis as a complication of UAC use is common, with an incidence range of 4.5 to 90%. [2][3][4][5] Complications of aortic thrombosis include gut ischemia, hypertension, decreased renal perfusion, complete aortic occlusion and congestive heart failure. [6][7][8][9] Thrombosis complicating UVC use is also common, with a reported incidence of 4.1 to 44%.…”

“…[6][7][8][9] Thrombosis complicating UVC use is also common, with a reported incidence of 4.1 to 44%. 4,10,11 There has been a recent flourish in the identification of genetic abnormalities associated with increased thrombotic risk. Genetic prothrombotic factors are more prevalent in patients with spontaneous and catheter-associated thrombosis compared to the general population.…”

Successful embolectomy of bilateral femoral artery thrombosis in neonate

“…2 Aortic thrombosis in newborn period is an infrequent but catastrophic event which is associated with predisposing conditions like umbilical artery catheterization, dehydration, polycythemia, cyanotic congenital heart disease, patent ductus arteriosus, sepsis, lupus anticoagulant and inherited defects in coagulation. [3][4][5][6][7][8][9] Most cases remain idiopathic. 10 Depending on the thrombus location, degree of aortic occlusion and involvement of other organs, aortic thrombosis clinical signs range from a completely asymptomatic presentation to a life threatening neonatal emergency.…”