Catheters linked thrombosis in neonates: a single center observational study

Area of Science:

• Neonatal Medicine
• Pediatric Thrombosis
• Vascular Access

Background:

• Central venous catheters (CVCs) are a primary risk factor for neonatal thrombosis.
• Neonatal thrombosis can significantly increase morbidity and mortality rates.
• Understanding CVC-associated thrombosis is crucial for improving neonatal outcomes.

Purpose of the Study:

• To determine the incidence of CVC-linked thrombosis in neonates.
• To identify potential risk factors for CVC-associated thrombosis in a neonatal intensive care unit (NICU).
• To analyze the association between various factors and thrombosis development.

Main Methods:

• An observational cohort study was conducted with 134 neonates receiving CVCs.
• Exclusion criteria included congenital anomalies, pre-existing thrombosis, or death within 7 days of catheter placement.
• Serial ultrasound and Doppler scans were used to detect thrombosis; logistic regression analyzed risk factors.

Main Results:

• The study found an incidence of 12% for catheter-related thrombosis (10.5 events per 1000 catheter-days).
• Univariate analysis identified femoral central venous lines, catheter dwell time, sepsis, packed red blood cell (PRBC) transfusions, and low platelet count as risk factors.
• Multivariate analysis revealed PRBC transfusion as the only significant risk factor (OR 5.768).

Conclusions:

• Sepsis, femoral line insertion, low platelet count, and PRBC transfusions are important factors in predicting neonatal thrombosis risk.
• PRBC transfusion, even through peripheral intravenous lines (PIVs), emerged as the strongest predictor of CVC-linked thrombosis.
• These findings highlight the need for careful monitoring and management of transfusions in neonates with CVCs.