Bachelor of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Pediatr Blood Cancer. 2020 Apr;67(4):e28114. doi: 10.1002/pbc.28114. Epub 2019 Dec 26.
Neonatal inferior vena cava syndrome (IVCS), though uncommon, is associated with significant morbidity and mortality. Information on risk factors, diagnosis, treatment, and outcomes is limited. This review comprised 61 neonates across 33 reports. Thrombosis occurred in 98% and 42% involved a central venous catheter. Diagnosis was mainly established by ultrasound in 82%. Therapeutically, heparin was employed in 36% and thrombolysis in 18% of the cases. The overall mortality was 23%. An algorithm of clinical signs, investigation, and management is presented. Well-designed prospective studies are needed to establish a concrete investigational approach to neonatal IVCS and institute safe, evidence-based treatment.
新生儿下腔静脉综合征(IVCS)虽不常见,但与较高的发病率和死亡率相关。目前有关其危险因素、诊断、治疗和结局的信息有限。本综述共纳入 33 项研究中的 61 例新生儿。98%的患儿存在血栓形成,42%的血栓与中心静脉导管相关。82%的患儿主要通过超声诊断。治疗上,36%的患儿使用肝素,18%的患儿使用溶栓治疗。总的死亡率为 23%。本文提出了一套基于临床表现、检查和处理的方案。需要开展精心设计的前瞻性研究,以明确新生儿 IVCS 的具体诊疗方法,并制定安全、基于证据的治疗方案。