Risk Factors Linked to Central Catheter-Associated Thrombosis in Critically Ill Infants in the Neonatal Intensive Care Unit

Lambert, I; Tarima, Sergey; Uhing, Michael R.; Cohen, Susan

doi:10.1055/s-0038-1667377

Cited by 8 publications

(4 citation statements)

References 26 publications

(16 reference statements)

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“…8 cohort studies [ 16 , 19 , 25 – 28 , 30 , 31 ] described the incidence of thrombosis. Meta-analysis showed a significant heterogeneity across studies (I 2 = 99%, P < 0.01), so a random effects model was used for meta-analysis, and the incidence of thrombosis in children (per year) was 2% (95%CI (1%-2%), P < 0.01) (Fig.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

Song

Zhao

et al. 2023

BMC Pediatr

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Background Thrombosis is a serious condition in children and neonates. However, the risk factors for thrombosis have not been conclusively determined. This study aimed to identify the risk factors for thrombosis in children and neonates in Intensive Care Unit (ICU) through a meta-analysis to better guide clinical treatment. Methods A systematic search of electronic databases (PubMed, Embase, Cochrane Library, WOS, CNKI, Wanfang, VIP) was conducted to retrieve studies from creation on 23 May 2022. Data on the year of publication, study design, country of origin, number of patients/controls, ethnicity, and type of thrombus were extracted. The publication bias and heterogeneity between studies were assessed, and pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed or random effects models. Results A total of 18 studies met the inclusion criteria. The incidence of thrombosis in children was 2% per year (95% CI 1%-2%, P < 0.01). Infection and sepsis (OR = 1.95, P < 0.01), CVC (OR = 3.66, [95%CL 1.78–7.51], P < 0.01), mechanical ventilation (OR = 2.1, [95%CL1.47–3.01], P < 0.01), surgery (OR = 2.25, [95%CL1.2–4.22], P < 0.01), respiratory distress (OR = 1.39, [95%CL0.42–4.63], P < 0.01), ethnicities (OR = 0.88, [95%CL 0.79–0.98], P = 0.78), gestational age (OR = 1.5, [95%CL1.34–1.68], P = 0.65)were identified as risk factors for thrombosis. Conclusions This meta-analysis suggests that CVC, Surgery, mechanical ventilation, Infection/sepsis, gestational age, Respiratory distress, and different ethnicities are risk factors for thrombosis in children and neonates in ICU. These findings may help clinicians to identify high-risk patients and develop appropriate prevention strategies. Trial registration PROSPERO (CRD 42022333449).

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Section: Resultsmentioning

confidence: 99%

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

Song

Zhao

et al. 2023

BMC Pediatr

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“…[8] CVCs were used more frequently in intensive care unit (ICU) inpatients given their critical illness. [3,[9][10][11] Many studies on CRVT in ICU patients have been reported, and it has been found that venous catheter diameter, number of lumens, intubation site, blood transfusion, parenteral nutrition, sedation, and other factors are related to CVC-related thrombosis. [12][13][14] Critical and severe patients are usually treated in the ICU.…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study of disease-related risk factors for central venous catheter-related symptomatic thrombosis in intensive care unit inpatients

et al. 2021

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“…Patients undergoing operation or staying in the intensive care units experience a long period of supine position, which lead to hemodynamic changes. Under these circumstances, monocytes flowing in blood vessels will be easy to adhere to the inflamed or damaged vascular endothelial cells, aggravating vascular injury or thrombosis [17,18]. This is detrimental to the patient's recovery.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Attenuates Monocyte-Endothelial Adherence via Inhibiting Connexin43 on Vascular Endothelial Cells

Chai

Liu

et al. 2020

Mediators of Inflammation

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Current studies have identified the multifaceted protective functions of dexmedetomidine on multiple organs. For the first time, we clarify effects of dexmedetomidine on monocyte-endothelial adherence and whether its underlying mechanism is relative to connexin43 (Cx43), a key factor regulating monocyte-endothelial adherence. U937 monocytes and human umbilical vein endothelial cells (HUVECs) were used to explore monocyte-endothelial adherence. Two special siRNAs were designed to knock down Cx43 expression on HUVECs. U937-HUVEC adhesion, adhesion-related molecules, and the activation of the MAPK (p-ERK1/2, p-p38, and p-JNK1/2) signaling pathway were detected. Dexmedetomidine, at its clinically relevant concentrations (0.1 nM and 1 nM), was given as pretreatments to HUVECs. Its effects on Cx43 and U937-HUVEC adhesion were also investigated. The results show that inhibiting Cx43 on HUVECs could attenuate the contents of MCP-1, soluble ICAM-1 (sICAM-1), soluble VCAM-1 (sVCAM-1), and the nonprocessed variants of the adhesion molecules ICAM-1 and VCAM-1 and ultimately result in U937-HUVEC adhesion decrease. Meanwhile, the activation of MAPKs was also inhibited. U0126 (inhibiting p-ERK1/2) and SB202190 (inhibiting p38) decreased the contents of MCP-1, sICAM-1, and sVCAM-1, but SP600125 (inhibiting p-JNK1/2) had none of these effects. ICAM-1 and VCAM-1 could be regulated in a similar way. Dexmedetomidine pretreatment inhibited Cx43 on HUVECs, the activation of MAPKs, and U937-HUVEC adhesion. Therefore, we conclude that dexmedetomidine attenuates U937-HUVEC adhesion via inhibiting Cx43 on HUVECs modulating the activation of MAPK signaling pathways.

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Risk Factors Linked to Central Catheter-Associated Thrombosis in Critically Ill Infants in the Neonatal Intensive Care Unit

Abstract: We conclude that clinically identifiable CT is rare in the neonatal population. Furthermore, catheter-specific characteristics are predictive for CT and require further investigation.

Cited by 8 publications

References 26 publications

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

Epidemiology and risk factors for thrombosis in children and newborns: systematic evaluation and meta-analysis

A retrospective cohort study of disease-related risk factors for central venous catheter-related symptomatic thrombosis in intensive care unit inpatients

Dexmedetomidine Attenuates Monocyte-Endothelial Adherence via Inhibiting Connexin43 on Vascular Endothelial Cells

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