A 10-Year Single-Center Experience of Catheter-Related Thrombosis in Neonates

Objective: Central catheterization is one of the major iatrogenic risk factors of neonatal thrombosis. We conducted this study to investigate the clinical features of neonatal catheter-related thrombosis. Methods: This is a single-center retrospective study which reviewed medical records of neonates who were admitted to our neonatal intensive care unit (NICU) from May 2010 to April 2020. Results: Among the 4,978 neonates hospitalized in our NICU, 2,773 neonates were inserted central catheter. Thirteen neonates (0.47%) were diagnosed with catheter-related thrombosis. Median gestational age was 29 weeks 5 days and median birth weight was 1,080 g. The incidence of thrombosis with each catheter was 0.64% for infants with umbilical artery catheter, 1.35% with umbilical venous catheter, 0.28% with peripherally inserted central catheter and 0.38% with subclavian venous catheter. The type of thrombus was 69.2% as venous and 15.4% as intracardiac and arterial, respectively. The symptoms that led to the diagnosis of thrombosis were color changes, swelling in the insertion site and cardiac murmur. Doppler ultrasound and echocardiography were performed for diagnosis. Their postnatal age at diagnosis was 22±12 days and the mean duration of catheterization was 10±4 days. Seven neonates (53.8%) were treated with low molecular weight heparin. Eight neonates (61.5%) demonstrated resolution of thrombosis. Mean time for resolution was 198±212 days. There was one mortality (7.7%) from pulmonary thromboembolism related to the superior vena cava thrombosis. Conclusion: In newborns, the risk of thrombosis is high and careful monitoring is required. Antithrombotic treatment should be considered in newborn with clinically significant thrombosis and follow- up observation is also required.