Walid El-Naggar1, Eugene W Yoon2, Douglas McMillan3, Jehier Afifi3, Souvik Mitra3, Balpreet Singh3, Orlando da Silva4, Shoo K Lee2,5,6, Prakesh S Shah2,5. 1. Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada. walid.el-naggar@iwk.nshealth.ca. 2. Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada. 3. Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada. 4. Department of Pediatrics, London Health Sciences Centre, Western University, London, ON, Canada. 5. Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada. 6. Department of Obstetrics and Gynecology and Dalla Lana School of Public Health, University of Toronto, Totonto, ON, Canada.
Abstract
OBJECTIVE: To assess the rate, location, risk factors, management, and outcomes of neonatal thrombosis (NT). DESIGN: A retrospective study investigating infants admitted to NICUs in Canadian Neonatal Network between January 2014 and December 2016 and diagnosed with NT. Each infant with NT was matched with an infant without NT. RESULTS: Of 39,971 infants, 587 (1.5%) were diagnosed with NT: 440 (75%) venous, 112 (19%) arterial, 29 (5%) both. NT rate was 1.4% in full-term and 1.7% in preterm infants. Venous thrombi occurred most commonly in the portal vein and arterial thrombi in the cerebral artery. Conservative management and low molecular weight heparin were the most common treatment modalities. Hospital stay was longer (p < 0.001) in the NT patients, but mortality was similar. CONCLUSIONS: NT was diagnosed in ~15/1000 NICU admissions and most commonly in the portal vein and cerebral arteries. Management varied based on the type and location of thrombi. Large multicenter trials are needed to address the best management strategies.
OBJECTIVE: To assess the rate, location, risk factors, management, and outcomes of neonatal thrombosis (NT). DESIGN: A retrospective study investigating infants admitted to NICUs in Canadian Neonatal Network between January 2014 and December 2016 and diagnosed with NT. Each infant with NT was matched with an infant without NT. RESULTS: Of 39,971 infants, 587 (1.5%) were diagnosed with NT: 440 (75%) venous, 112 (19%) arterial, 29 (5%) both. NT rate was 1.4% in full-term and 1.7% in preterm infants. Venous thrombi occurred most commonly in the portal vein and arterial thrombi in the cerebral artery. Conservative management and low molecular weight heparin were the most common treatment modalities. Hospital stay was longer (p < 0.001) in the NT patients, but mortality was similar. CONCLUSIONS: NT was diagnosed in ~15/1000 NICU admissions and most commonly in the portal vein and cerebral arteries. Management varied based on the type and location of thrombi. Large multicenter trials are needed to address the best management strategies.
Authors: Alan R Schroeder; David M Axelrod; Norman H Silverman; Erika Rubesova; Elisabeth Merkel; Stephen J Roth Journal: Pediatr Crit Care Med Date: 2010-07 Impact factor: 3.624
Authors: H A van Elteren; H S Veldt; A B Te Pas; A A W Roest; F J Smiers; W J Kollen; A Sramek; F J Walther; E Lopriore Journal: Int J Pediatr Date: 2011-08-11