Abstract:The female infant in this case study was admitted to the hospital 4 hours after birth due to preterm birth and respiratory distress. On the third day after birth, peripherally inserted central venous catheter (PICC) catheterization was performed. On day 42, thrombus was found at the entrance of the right atrium from the inferior vena cava during a cardiac ultrasound, and it was considered to be related to PICC placement. Low-molecular-weight heparin and urokinase were given. After two weeks of treatment, ultrasonic monitoring showed thrombus shrinkage. No bleeding or pulmonary embolism occurred during the treatment. The patient discharged after improvement. This article mainly introduces a multidisciplinary team approach to diagnosis and treatment of PICC-related thrombosis in neonates.
LI Shu-Juan,ZHANG Ke,WANG Huan-Huan et al. Peripherally inserted central venous catheter-related thrombosis in a neonate[J]. CJCP, 2023, 25(6): 658-662.
Park CK, Paes BA, Nagel K, et al. Neonatal central venous catheter thrombosis: diagnosis, management and outcome[J]. Blood Coagul Fibrinolysis, 2014, 25(2): 97-106. PMID: 24477225. DOI: 10.1097/MBC.0b013e328364f9b0.
Narang S, Roy J, Stevens TP, et al. Risk factors for umbilical venous catheter-associated thrombosis in very low birth weight infants[J]. Pediatr Blood Cancer, 2009, 52(1): 75-79. PMID: 18680150. PMCID: PMC2585148. DOI: 10.1002/pbc.21714.
Monagle P, Chan AKC, Goldenberg NA, et al. Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines[J]. Chest, 2012, 141(2 Suppl): e737S-e801S. PMID: 22315277. PMCID: PMC3278066. DOI: 10.1378/chest.11-2308.
Yang JY, Williams S, Brand?o LR, et al. Neonatal and childhood right atrial thrombosis: recognition and a risk-stratified treatment approach[J]. Blood Coagul Fibrinolysis, 2010, 21(4): 301-307. PMID: 20305543. DOI: 10.1097/MBC.0b013e3283333c7c.
Yang JY, Williams S, Brand?o LR, et al. Neonatal and childhood right atrial thrombosis: critical clot size[J]. Blood Coagul Fibrinolysis, 2013, 24(4): 458. PMID: 23632382. DOI: 10.1097/MBC.0b013e32835b72d7.
Sol JJ, van de Loo M, Boerma M, et al. NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related thrombosis[J]. BMC Pediatr, 2018, 18(1): 84. PMID: 29475450. PMCID: PMC5824541. DOI: 10.1186/s12887-018-1000-7.