Clinical outcome of umbilical artery catheter-related thrombosis—a cohort study

• Published in: Journal of perinatology Vol. 32; no. 12; pp. 933 - 940
• Main Authors: Ergaz, Z, Simanovsky, N, Rozovsky, K, Leil, S Abu, Ofek-Shlomai, N, Revel-Vilk, S, Bar-Oz, B
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-12-2012; Nature Publishing Group
• Subjects: 692/499; 692/699/75/567; 692/700/1720; 692/700/565; Age Factors; Blood clot; Care and treatment; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Catheters; Clinical outcomes; Cohort analysis; Cohort Studies; Complications and side effects; Critically ill; Diseases; Female; Follow-Up Studies; Health aspects; Humans; Iatrogenic Disease - epidemiology; Infant, Newborn; Infants; Infants (Newborn); Intensive Care Units, Pediatric; Israel; Logistic Models; Male; Medical instruments; Medical treatment; Medicine; Medicine & Public Health; original-article; Patient outcomes; Pediatric Surgery; Pediatrics; Prevalence; Prospective Studies; Remission, Spontaneous; Renal artery; Risk analysis; Risk Assessment; Risk factors; Sex Factors; Survival Rate; Thromboembolism; Thrombosis; Thrombosis - diagnostic imaging; Thrombosis - epidemiology; Thrombosis - etiology; Treatment Outcome; Ultrasonography, Doppler, Color - methods; Ultrasonography, Doppler, Duplex - methods; Umbilical Arteries - diagnostic imaging; Umbilical Arteries - pathology; Israel; umbilical artery catheter-related thrombosis; duplex; prematurity; resistance index
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2012.4

Objective:
To reveal the incidence of umbilical artery catheter-related thrombosis (UACRT), the associated risk factors and the natural history of clot formation and regression.
Study Design:
A prospective cohort study. An umbilical artery catheter was inserted in 61 infants, who were evaluated and followed by serial duplex ultrasound studies for the development of UACRT, renal artery resistance index (RI) and clot resolution. Maternal and infant clinical variables were correlated with the characteristics of thrombi.
Result:
Nineteen infants developed UACRT, all resolved spontaneously without sequella; most had maximal length at the first evaluation. No correlation was found between the thrombus length and time to resolution. The RI did not differ between the infants with and without UACRT. After adjusting for possible confounding, catheter days was the only covariate associated with UACRT.
Conclusion:
Asymptomatic UACRT in our cohort was a self-resolving disease; it was associated with catheter days and did not necessitate medical treatment.