Accuracy of Doppler echocardiography for the diagnosis of thrombosis associated with umbilical venous catheters.
We conducted a prospective cohort study to determine the incidence of asymptomatic thrombosis associated with an indwelling umbilical venous catheter (UVC) and to evaluate the diagnostic accuracy of Doppler echocardiography compared with contrast venography. The mean birth weight (SD) of the 47 eligible infants was 1962 (1101.5) g, and the mean gestational age (SD) was 32.2 (5.4) weeks. Catheters remained in situ for a mean (SD) of 7.0 (2.3) days. Thrombi were detected by venogram in 14 cases (30%). The accuracy of the echocardiographic diagnoses was poor, with sensitivities of 21%, 43%, and 21%, respectively, for the 3 cardiologists. Corresponding specificities were 91%, 76%, and 94%. We conclude that asymptomatic thrombosis is common in sick newborn infants with UVCs. Contrast venography is required to accurately diagnose such thrombi in affected patients.
Roy
Madan
M
Departments of Pediatrics, Radiology, and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Turner-Gomes
Sophronia
S
Gill
Gerald
G
Way
Clifton
C
Mernagh
John
J
Schmidt
Barbara
B
D002404:Catheterization / Q000009:adverse effects*; D015150:Echocardiography, Doppler; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D014471:Umbilical Veins