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Catheter related line thrombosis newborn

K Thom, C Male, C Mannhalter, P Quehenberger, E Mlczoch, D Luckner, M Marx, A Hanslik
BACKGROUND AND OBJECTIVE: Central venous lines (CVLs) are the major exogenous risk factor for deep venous thrombosis (DVT) in children. The study objective was to assess whether endogenous prothrombotic conditions contribute to the risk of CVL-related DVT in children. METHODS: This was a cohort study of consecutive children with heart disease requiring CVLs for perioperative care. CVLs were inserted percutaneously in the upper venous system and patients received prophylaxis with continuous unfractionated heparin (50 u kg(-1)  d(-1) )...
October 2014: Journal of Thrombosis and Haemostasis: JTH
Maisam Abu-El-Haija, Jonathan Schultz, Riad M Rahhal
OBJECTIVES: Parenteral nutrition is essential for the growth and nutrition of patients with intestinal failure (IF). Catheter-related bloodstream infections (CRBSI) are a major complication of parenteral nutrition use. Few retrospective studies have shown that 70% ethanol lock (ETL) therapy for central lines can reduce the infection rate. Studies assessing line breakage, thrombosis, and replacement with the use of ETL are lacking in the pediatric literature. METHODS: The present study is a retrospective chart review, with a primary outcome of CRBSI rate per 1000 catheter days, and secondary outcomes of line thrombosis, line breakage requiring repair, and line replacement rates with use of ETL compared with heparin locks...
June 2014: Journal of Pediatric Gastroenterology and Nutrition
Jeffrey W Miller, Dien N Vu, Paul J Chai, Janet H Kreutzer, J Blaine John, David F Vener, Jeffrey P Jacobs
BACKGROUND: A central venous catheter located in the jugular or subclavian vein provides rapid, reliable vascular access for pediatric heart surgery. However, intravascular catheters are associated with vessel injury. Stenosis or thrombosis of central veins in the upper body can lead to 'superior vena cava syndrome' with markedly elevated venous pressures in the head and neck, causing facial swelling and headaches. This complication may be especially serious for patients with superior cavopulmonary (Glenn) or total cavopulmonary (Fontan) circulation...
November 2013: Paediatric Anaesthesia
Jeremy O'Brien, France Paquet, Richard Lindsay, David Valenti
BACKGROUND: Inappropriate catheter requests at the McGill University Health Centre (MUHC) led to significantly increased costs and early catheter malfunction or infection. Dual-lumen catheters were often requested and inserted when only a single lumen was required, and inappropriate catheter care on the wards led to early infection or thrombosis. METHODS: A full-time registered nurse was hired to analyze and transform the vascular access program of the MUHC. Catheter selection was streamlined on the basis of clinical unit need...
November 2013: Journal of the American College of Radiology: JACR
A Vivanco Allende, C Rey Galán, M V Rodríguez de la Rúa, F Alvarez García, A Medina Villanueva, A Concha Torre, J Mayordomo Colunga, P Martínez Camblor
OBJECTIVE: To analyse the incidence of thrombosis and obstruction associated with central venous lines (CVL) inserted in critically ill children, and to determine their risk factors. DESIGN: Prospective observational study in a Pediatric Intensive Care Unit in a University Hospital. MATERIAL AND METHOD: An analysis was made of 825 CVL placed in 546 patients. Age, gender, weight, type of catheter (lines, size, and brand), final location of the catheter, mechanical ventilation, type of sedation and analgesia used, initial failure by the doctor to perform CVL catheterization, number of attempts, CVL indication, admission diagnosis, emergency or scheduled procedure, and delayed mechanical complications (DMC)...
September 2013: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Maria Sellitto, Francesco Messina
Very low birth weight and other critically ill neonates require prolonged vascular access, which is achieved in current practice with central venous catheters. The initiation of adequate parenteral nutrition and prolonged intravenous medications represent the most important applications. Central vascular access in neonates is associated with a high risk for mechanical, infectious and thrombotic complications. The use of central lines is the most common cause for thrombosis in neonates and infants. The management of line-related thrombosis is based on expert opinion guidelines and is largely dependent on patient symptoms and the further requirement of the catheter...
October 2012: Journal of Maternal-fetal & Neonatal Medicine
Shoshana Revel-Vilk, Zivanit Ergaz
Although the use of central lines has many valuable applications in neonates and infants, they may cause serious mechanical, infectious and thrombotic complications. In fact, the use of central lines is the main cause for thrombosis in this age group. The frequency of central-line-related thrombosis in neonates and infants is reported to be as low as 1% when including only symptomatic cases, around 44% when systematically screened for thrombosis, and as high as 65% in autopsy studies. The risk factors for line-related thrombosis in neonates and infants include those associated with the underlying medical conditions, the duration of the line in situ, the placement of the umbilical artery catheter and the therapy used through the line...
December 2011: Seminars in Fetal & Neonatal Medicine
K Nagel, R Tuckuviene, B Paes, A K Chan
BACKGROUND: Neonatal aortic thrombosis is a rare occurrence, but can be fatal. Treatment of this condition is hampered by the lack of large studies involving this pediatric population. Reporting of this condition is also not standardized. METHODS: The purpose of this review is to collate available literature on the incidence, risk factors, presentation, treatment and outcome of neonatal aortic thrombosis as well as suggest a treatment model. RESULTS: A Medline search of PubMed, OVID and Cochrane databases was undertaken using the key words "neonatal", "infant", "aorta", "aortic", "thrombosis", "thrombus" and "clot"...
May 2010: Klinische Pädiatrie
Vered Kakzanov, Paul Monagle, Anthony K C Chan
Thromboembolism is an established complication of long-term parenteral nutrition (PN) administration which requires central venous lines in the pediatric population. Predisposing factors that increase the risk of thrombosis, as well as prophylaxis and treatment guidelines in this specific population, are not clearly defined. We performed a computerized search of PubMed, OVID databases, and pertinent articles from reference lists of related review papers. This review summarizes currently available data on the rates of thromboembolism in the pediatric population receiving long-term PN and concludes that control of factors such as location of catheter, duration of nutrition support, and prophylaxis with heparin or anticoagulants may reduce the rates of thrombosis in this patient population, although most data on the matter are inconclusive...
January 2008: JPEN. Journal of Parenteral and Enteral Nutrition
Courtney D Thornburg, P Brian Smith, Mary Laura Smithwick, C Michael Cotten, Daniel K Benjamin
INTRODUCTION: Peripherally inserted catheters are essential for infants in the neonatal intensive care nursery for administration of medications, parenteral nutrition and blood transfusions. We hypothesized that there is an association between catheter associated thrombosis and catheter associated blood stream infection. The primary objective of this study was to determine the association between catheter associated blood stream infection (CABSI) and catheter-related thrombosis in the Neonatal Intensive Care Unit...
2008: Thrombosis Research
E Desruennes
Central venous catheterisation under two-dimensional ultrasound (US) guidance has been proved to be quicker and safer than the classical landmark method in both adults and children. In the literature US guidance with sterile dressing of the probe is the 'gold-standard'. Another way to use US is simple preoperative US location followed either by blind puncture, either by US guided puncture when difficulties are expected: small infants (<15 kg), small diameter or collapses of the vein, multiple unsuccessful attempts during blind technique...
April 2006: Annales Françaises D'anesthèsie et de Rèanimation
Christoph Male, Jim A Julian, Patricia Massicotte, Michael Gent, Lesley Mitchell
Venous thromboembolic events (VTE) in children are frequently associated with central venous lines (CVL). Identifying risk factors related to CVL management could potentially minimize CVL-related thrombotic complications. The objectives of the study were to assess whether CVL location, type, size, and duration of placement are associated with the incidence of VTE in children. The study was a prospective, multicentre cohort study in a general pediatric population requiring CVL. Data on CVL characteristics were documented prospectively using standardized case report forms...
September 2005: Thrombosis and Haemostasis
S Sridhar, Niranjan Thomas, Sathish T Kumar, Atanu Kumar Jana
The use of a central venous catheter may occasionally be associated with complications like sepsis, effusions and thrombosis. Migration of the central catheter is an unusual complication that often goes unrecognized. This case report is of a neonate who developed hydrothorax resulting from a migrating central line and highlights the need for a high level of clinical suspicion in diagnosing catheter related problems.
September 2005: Indian Journal of Pediatrics
N S Kabra, M Kumar, S S Shah
BACKGROUND: Multiple lumen umbilical venous catheters (ML-UVCs) instead of single lumen UVCs (SL-UVCs) may decrease the need for additional venous lines. Although it seems self-evident that ML-UVCs would reduce the need of additional venous lines, the rates of associated complications might be different. OBJECTIVES: To compare the effectiveness and the safety of ML-UVCs versus SL-UVCs in terms of need of additional vascular access, rates of complications, morbidity and mortality in newborn infants...
2005: Cochrane Database of Systematic Reviews
G T Gerotziafas
The incidence of venous thromboembolism (VTE) is increasing in children as a result of therapeutic advances and improved clinical outcome in primary illnesses that previously caused mortality. VTE is mostly diagnosed in hospitalized children, especially sick newborns with central venous catheters and older children with a combination of risk factors. Infants older than 3 months and teenagers are the largest groups developing VTE. The most important triggering risk factors are the presence of central venous lines, cancer and chemotherapy...
September 2004: International Angiology: a Journal of the International Union of Angiology
Praveen Kumar, Debra A Hoppensteadt, M Margaret Prechel, Ruth B Deddish, Jeanine M Walenga
Heparin is frequently used in preterm infants to prolong the patency of intravascular catheters. The aim of this study was to evaluate the prevalence of heparin-dependent platelet-activating antibodies in newborns. A cross-section of all preterm newborn infants expected to require heparin to maintain patency of a central venous access line were enrolled. A blood sample was obtained soon after birth before heparin exposure to exclude the possibility of placental transfer of maternal heparin-dependent platelet-activating antibodies...
October 2004: Clinical and Applied Thrombosis/hemostasis
Stefan Kuhle, Patricia Massicotte, Anthony Chan, Margaret Adams, Mohamed Abdolell, Gabrielle de Veber, Lesley Mitchell
Thromboembolism (TE) has recently been recognized as a clinical entity in children. Determining the clinical characteristics of pediatric TE is an important first step in dealing with this new disorder. The paper summarizes 1776 consecutive children with systemic TE referred to 1-800-NO-CLOTS telephone consultation service. 1-800-NO-CLOTS is a free consultation service for clinicians managing pediatric TE. Patient information was collected immediately using standardized forms. In children with systemic TE, infants under one year of age (47%) including neonates (26%) represented the largest distinct pediatric age group...
October 2004: Thrombosis and Haemostasis
R A van Lingen, W Baerts, A C M Marquering, G J H M Ruijs
AIM: This study assesses the improvement in outcome for newborn infants by decreasing major complications associated with intravenous fluid therapy by using an in-line filter, and evaluates the economical impact this might have in relation to daily changing of i.v. lines. METHODS: In a prospective controlled study, 88 infants were randomly assigned to receive either filtered (except for lipids, blood and blood products) or non-filtered infusions via a central catheter...
May 2004: Acta Paediatrica
Cláudio D'Elia, Marta S Correia, Suzana D de Oliveira, Nilse M M Barbosa
OBJECTIVES: To present a case of central venous line misplacement with vasculo-pulmonary fistula and severe respiratory consequences in a newborn. To review the literature concerning respiratory and non-respiratory complications related to the introduction of percutaneously placed central venous lines in children. REPORT: Evaluative and diagnostic data were described after patient chart review. A premature newborn was admitted in a NICU after delivery for treatment of low-grade hyaline membrane disease and infection manifested afterwards...
July 2002: Jornal de Pediatria
Janet Pettit
Peripherally inserted central catheters (PICCs) are frequently placed in neonates to optimize nutrition and provide stable infusions of critical medications into the central vascular system. PICCs have been associated with a number of device-specific complications that can manifest during insertion, while the line is indwelling, and/or after the removal of the line. The first article of this series in Focus on the Physical, titled "Assessment of Infants With Peripherally Inserted Central Catheters: Part I. Detecting the Most Frequently Occurring Complications," presented assessment strategies to detect common complications such as catheter occlusions and catheter-related bloodstream infections...
February 2003: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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