Ultrasonic detection of complications following umbilical arterial catheterization in the neonate.

Oppenheimer, D A; Carroll, B A; Garth, K E

doi:10.1148/radiology.145.3.7146394

Cited by 53 publications

(18 citation statements)

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“…21,22 Ultrasound scan has been used successfully to identify large vessel thrombus. 5,26 It is a safe, readily available test that can be done at the bedside. As umbilical catheters (UCs) have a relatively high incidence of associated thrombosis, we hypothesized that having one or more of these genetic prothrombotic mutations (FVL, PTm and/or MTHFR) would increase the risk of UC-associated thrombosis.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2007

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Objective: To evaluate the prevalence of hereditary prothrombotic mutations, and their effect on the incidence and severity of umbilical arterial or venous catheter (UAC or UVC)-associated thrombosis.Study Design: All neonates with a UAC or UVC were studied prospectively for the presence, severity and timing of thrombosis with duplex Doppler ultrasound scan. Genetic testing for factor V Leiden (FVL), prothrombin mutation (PTm) and methylene-tetrahydrofolate reductase (MTHFR) mutations was performed using PCR and restriction fragment length polymorphism assays.Result: Umbilical catheter (UC)-associated thrombosis developed in 16/53 (31%) neonates; 23% of UACs and 22% of UVCs were associated with thrombosis. The prevalence of a significant prothrombotic mutation was present in 10/51 (20%) of infants: FVL (8%), MTHFR667 homozygosity (10%), MTHFR1298 homozygosity (2%) and PTm (0%). There was no increase in the risk of UC-associated thrombus in patients carrying these prothrombotic mutations; our study had the power to detect a 2.5-fold increased risk of thrombosis for any of these significant mutations. In addition, MTHFR667 heterozygosity was found in 41% of infants and MTHFR1298 heterozygosity in 52% and also were not associated with increased risk of UC-associated thrombus. The risk of MTHFR double heterozygosity (db het) was 14%, the risk of a significant or db het was 17/51 (33%) and the risk of any mutation was 90%.Conclusion: Prothrombotic genetic mutations are common in our Neonatal Intensive Care Unit population but do not appear to increase the risk of UC-associated thrombosis.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2007

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“…A simple, noninvasive method to examine the aorta in neonates for thrombosis by using real-time sonography has been recently described by Oppenheimer and others [2][3][4]. We undertook a study to (1) determine the frequency of umbilical-artery-catheter thrombosis, (2) examine risk factors for it, (3) define the associated mortality and morbidity, (4) …”

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confidence: 99%

Sonographic detection of neonatal umbilical-artery thrombosis: clinical correlation

Seibert¹,

Taylor²,

Williamson³

et al. 1987

American Journal of Roentgenology

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“…2,5 It has been reported that 1% of newborn infants with catheters have symptoms indicative of thrombosis, 6 and it is estimated that the incidence of catheter-associated asymptomatic thrombosis is 20-30%. [7][8][9][10][11] An adequate management of thrombosis is generally complicated due to the extrapolation of adult management techniques. However, over the past years, major differences related to age have been observed in this condition (epidemiology, diagnostic tests, pharmacokinetics of antithrombotic agents), which have favored the use of diagnostic and therapeutic procedures appropriate for this period in life.…”

Section: Introductionmentioning

confidence: 99%

Thrombosis in newborn infants

Bacciedoni

Attie

Donato³

et al. 2016

Arch Argent Pediat

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The incidence of thrombosis is higher among newborn infants than in any other stage of pediatric development. This fact is the consequence of labile characteristics of the neonatal hemostatic system, in addition to exposure to multiple risk factors and the wide use of vascular catheters. Venous thromboses, which mainly affect the limbs, the right atrium and renal veins, are more frequently seen than arterial thromboses. A stroke may be caused by the occlusion of the arterial flow entering the brain or by occlusion of its venous drainage system. Purpura fulminans is a very severe condition that should be treated as a medical emergency, and is secondary to severe protein C deficiency or, less frequently, protein S or antithrombin deficiency. Most thrombotic events should be managed with antithrombotic therapy, which is done with unfractionated and/or low molecular weight heparins. Purpura fulminans requires protein C replacement and/or fresh frozen plasma infusion. Thrombolytic therapy is done using tissue plasminogen activator and should only be used for life-, or limb-, or organthreatening thrombosis.

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Ultrasonic detection of complications following umbilical arterial catheterization in the neonate.

Cited by 53 publications

References 0 publications

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

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

Sonographic detection of neonatal umbilical-artery thrombosis: clinical correlation

Thrombosis in newborn infants

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