Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants and Groups
2.2. Clinical Presentation
2.3. Statistical Analysis
3. Results
3.1. PICC-Related Thromboses
3.2. Risk Factors for PICC-Related Venous Thrombosis
3.3. Clinical Features of PICC-Related Thrombosis
3.4. Treatment and Complications of Anticoagulation
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Groups | Number (n) | Gestational Age (Weeks) | Birthweight (g) | Male (%) |
---|---|---|---|---|
Thrombosis group | 7 | 30.8 ± 1.9 | 1380 (1130, 1740) | 71.4% (5/7) |
Non-thrombotic group | 28 | 30.8 ± 1.9 | 1295 (1122.5, 1500) | 57.1% (16/28) |
p value | 0.858 | 0.412 | 0.690 |
Risk Factors | Thrombus | Non-Thrombus | p Value |
---|---|---|---|
Numbers | 7 | 56 | |
Diabetes | 42.9% (3/7) | 21.4% (12/56) | 0.342 |
Hypertension | 42.9% (3/7) | 37.5% (21/56) | 1 |
Hypothyroidism | 0% (0/7) | 17.9% (10/56) | 0.585 |
Autoimmune disease | 28.6% (2/7) | 1.8% (1/56) | 0.03 |
Use of anticoagulants | 42.9% (3/7) | 7.1% (4/56) | 0.025 |
Use of antihypertensive drugs | 14.3% (1/7) | 17.9% (10/56) | 1 |
PICC beginning time (d) | 5 (1, 6) | 5 (3, 6) | 0.521 |
The tip in the correct position | 28.6% (2/7) | 42.9% (24/56) | 0.69 |
Left lower extremity vein | 28.6% (2/7) | 17.9% (10/56) | 0.609 |
Right lower extremity vein | 28.6% (2/7) | 16.1% (9/56) | 0.595 |
Left upper extremity vein | 28.6% (2/7) | 26.8% (15/56) | 0.667 |
Right upper extremity vein | 14.3% (1/7) | 39.3% (22/56) | 0.699 |
Wet lung | 71.4% (5/7) | 55.4% (31/56) | 0.689 |
RDS | 42.9% (3/7) | 30.4% (17/56) | 0.669 |
Aspiration syndrome | 0% (0/7) | 3.6% (2/56) | 1 |
Intrauterine infectious pneumonia | 0% (0/7) | 21.4% (12/56) | 0.329 |
PDA | 28.6% (2/7) | 55.4% (31/56) | 0.243 |
Pulmonary hypertension | 14.3% (1/7) | 3.6% (2/56) | 0.302 |
Cardiac insufficiency | 14.3% (1/7) | 1.8% (1/56) | 0.211 |
TTTS-recipient | 14.3% (1/7) | 3.6% (2/56) | 0.302 |
TTTS-donor | 14.3% (1/7) | 1.8% (1/56) | 0.211 |
Erythrocytosis | 0% (0/7) | 1.8% (1/56) | 1 |
Platelets before catheterization (×109/L) | 218 (96, 353) | 217 (175, 270.25) | 0.619 |
Thrombocytosis (≥500) | 14.3% (1/7) | 1.8% (1/56) | 0.211 |
Thrombocytopenia | 28.6% (2/7) | 8.9% (5/56) | 0.17 |
Feeding intolerance | 28.6% (2/7) | 17.9% (10/56) | 0.609 |
Upper gastrointestinal bleeding | 0% (0/7) | 5.4% (3/56) | 1 |
Asphyxia (mild to moderate) | 14.3% (1/7) | 16.1% (9/56) | 1 |
Use of ibuprofen | 0% (0/7) | 26.8% (15/56) | 0.182 |
Use of vasoactive drugs | 28.6% (2/7) | 12.5% (7/56) | 0.26 |
Variables | OR | p Value |
---|---|---|
Use of anticoagulants | 10.632 | 0.043 |
Cardiac insufficiency | 29.463 | 0.035 |
TTTS-donor | 29.463 | 0.035 |
Autoimmune disease | 14.239 | 0.090 |
Number | Vein Selection | Thrombus Location | Clinical Manifestations of Thrombosis | Platelet Count after Thrombosis (×109/L) | Protein C (%) | Protein S (%) | AT-III (%) | Time from Catheter Placement to Thrombosis (d) | Treatment (Drug) | Low Molecular Weight Heparin | Course of Treatment (d) | How Long to Pull out the PICC after Thrombosis (d) | Thrombus Duration (d) | Prognosis |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Left great saphenous vein | left hepatic portal vein | Systemic edema, lumbosacral and lower extremity edema | 273 | 25 | 56 | 64 | 1 | Nadroparin calcium injection | 100 IU/kg, qd, 10 IU/kg, q12h, 12 d | 12 | 12 | The thrombus did not disappear until discharge; 20 days after birth, the thrombus disappeared during outpatient reexamination | Parents requested to be discharged |
2 | Left great saphenous vein | left external iliac vein | Edema at the PICC placement area | 440 | 29 | 53 | 31 | 12 | the same as above | 100 IU/kg, q12h, 3 d; 75 IU/kg, q12h, 13 d | 17 | 0.5 before thrombus | 17 | get well |
3 | Right basilic vein | right subclavian vein | Edema of right upper extremity, right head and neck, shoulder and back | 57 | 26 | 70 | 43 | 36 | the same as above | 100 IU/kg, qd, 10 IU/kg, q12h, 4 d, 100 IU/kg, q12h, 2 d, 75 IU/kg, q12h, 3 d | 10 | 2 before thrombus | 5 | get well |
4 | Right great saphenous vein | right popliteal vein | The lower limbs on the catheterization side were swollen and purple in color | 273 | 17 | 21 | 22 | 6 | the same as above | 100 IU/kg, q12h, 3 d | 3 | 2 before thrombus | 3 | get well |
5 | Left basilic vein | left upper extremity vein | The upper limbs on the catheterization side were swollen and purple in color | 482 | - | - | - | 4 | the same as above | 100 IU/kg, q12h, 2 d (stopped due to intracranial hemorrhage) | 2 | 6 | 5 | get well |
6 | Right basilic vein | Right subclavian, axillary vein | The upper limbs on the catheterization side were swollen, purple, and the skin temperature increased | 57 | - | - | - | 1 | the same as above | 100 IU/kg, q12h, 2.5 d; abnormal coagulation; changed to 10 IU/kg, q12h, 26 d | 28 | 27 | 4 | get well |
7 | Right great saphenous vein | right saphenous vein | The lower limbs on the catheterization side were red, swollen, with calluses and tenderness | 254 | 17 | 47 | 37 | 5 | the same as above | 50 IU/kg, q12h, 3 d | 3 | 0 | 3 | get well |
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Zhu, W.; Zhang, H.; Xing, Y. Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants. Children 2022, 9, 1126. https://doi.org/10.3390/children9081126
Zhu W, Zhang H, Xing Y. Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants. Children. 2022; 9(8):1126. https://doi.org/10.3390/children9081126
Chicago/Turabian StyleZhu, Weiwei, Hua Zhang, and Yan Xing. 2022. "Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants" Children 9, no. 8: 1126. https://doi.org/10.3390/children9081126
APA StyleZhu, W., Zhang, H., & Xing, Y. (2022). Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants. Children, 9(8), 1126. https://doi.org/10.3390/children9081126