Efficacy of thromboresistant umbilical artery catheters in reducing aortic thrombosis and related complications.
Previous in vitro and in vivo reports suggest that catheters constructed of polyurethane with heparin bonded to the surface (HB-PU) are less thrombogenic than catheters made of polyvinyl chloride (PVC). A randomized trial sufficiently large (power 80%) to detect a reduction in the incidence of umbilical artery (UA) catheter complications, including aortic thrombus formation, from 45% to 20% was conducted in 125 infants. The infants were monitored for complications possibly related to the use of a UA catheter, such as systemic hypertension and abnormalities of lower extremity perfusion. The presence of aortic thrombi was assessed by ultrasound study 3.5 +/- 1.2 (SD) days and 11.1 +/- 2.3 days after insertion of the catheter. The use of HB-PU umbilical catheters did not lead to a significant reduction in the incidence of complications and aortic thrombi compared with the use of PVC catheters. The lack of reduction may have been related to the prolonged duration of catheter use in both groups. A much larger study would have been required to detect a smaller, but perhaps clinically significant, reduction in catheter-associated complications.
D001011:Aorta; D002404:Catheterization / Q000009:adverse effects*; D004868:Equipment Failure; D005069:Evaluation Studies as Topic; D006493:Heparin; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007231:Infant, Newborn; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply; D011140:Polyurethanes; D011897:Random Allocation; D013927:Thrombosis / Q000517:prevention & control*; D014469:Umbilical Arteries
D011140:Polyurethanes; D006493:Heparin