Division of Neonatology, Ankara Child Health, Hematology, Oncology, Research Hospital, Ankara, Turkey.
Thromb Res. 2012 Nov;130(5):725-8. doi: 10.1016/j.thromres.2012.07.018. Epub 2012 Aug 16.
To investigate umbilical venous catheter (UVC) related thrombosis by Doppler echocardiographic evaluation of neonates infused with heparin or placebo.
We conducted a prospective study to determine UVC-related thrombosis in term and nearterm neonates. Heparin or placebo (0.5 IU/mL) was infused at a rate of 1 mL/hr to the study and control group. Doppler echocardiography was performed at 1, 3, and 5 days after UVC insertion.
Forty-six neonates (63% males) with a mean gestational age of 38.2 ± 1.8 weeks, and a mean birth-weight of 2993 ± 563 grams were included. No UVC-related thrombosis was observed in the study group, which included 19 neonates. Among the 27 neonates in the control group, one neonate developed UVC-related thrombosis. There were no statistical differences between the groups for gestational age, birth weight, postnatal age, UVC duration, mortality, mechanical ventilation, and inotrope requirement, and hemagram or coagulation profile. The complications were as follows, mild pulmonary hemorrhage, 6.5% (3); leak-out, 4.3% (2); peritoneal leakage, 2.2% (1); occlusion, 2.2% (1); gastrointestinal findings, 6.5% (3); sepsis, 10.9% (5); and catheter-related thrombosis, 2.2% (1).
This study demonstrated that heparin infusion of 0.5 IU/mL through the UVC had no effect on catheter-related thrombosis in term and near-term neonates. Randomized controlled trials are necessary to conclusively evaluate the effect of heparin on UVC-related thrombosis.
通过多普勒超声心动图评估输注肝素或安慰剂的新生儿的脐静脉导管（UVC）相关血栓形成。
我们进行了一项前瞻性研究，以确定足月和近足月新生儿的 UVC 相关血栓形成。研究组和对照组以 1 mL/hr 的速度输注肝素或安慰剂（0.5 IU/mL）。UVC 插入后 1、3 和 5 天进行多普勒超声心动图检查。
46 名新生儿（63%为男性），平均胎龄为 38.2±1.8 周，平均出生体重为 2993±563 克。研究组包括 19 名新生儿，未观察到 UVC 相关血栓形成。对照组 27 名新生儿中，有 1 名发生 UVC 相关血栓形成。两组在胎龄、出生体重、出生后年龄、UVC 持续时间、死亡率、机械通气和儿茶酚胺需求以及血常规或凝血谱方面无统计学差异。并发症如下：轻度肺出血，6.5%（3 例）；漏出，4.3%（2 例）；腹膜渗漏，2.2%（1 例）；阻塞，2.2%（1 例）；胃肠道表现，6.5%（3 例）；败血症，10.9%（5 例）；和导管相关血栓形成，2.2%（1 例）。
本研究表明，通过 UVC 输注 0.5 IU/mL 的肝素对足月和近足月新生儿的导管相关血栓形成没有影响。需要进行随机对照试验来明确评估肝素对 UVC 相关血栓形成的影响。
