[Catheter-related thrombosis and its prevention in infancy].
Vascular catheters are the most important cause of thromboembolism in neonates. Additionally, a concomittant genetic predisposition with the well-known mutations is often present. In order to understand the pathology, knowledge about the specific condition of the newborn is important, especially concerning the altered hemostatic balance. For indications the specific situation of the very small infant is to be considered, e. g. the increased risk of cerebral bleeding in the first days of life of prematures. Therefore, careful consideration of indication and contraindications is mandatory. To avoid catheter-related thrombosis different schedules of prophylaxis are well-tried, especially low dose heparinization (sometimes as continuous infusion) is recommended for different types of vascular access. In neonates specific organ-related complications of umbilical catheters are to be considered. For the early diagnosis of catheter-related thrombosis, attention should be given to its first signs. Thrombolytic therapy is worth to be considered. However, the state of the patient and the dynamic of thrombus growth must be taken into account.
Hentschel
R
R
Zentr. f. Kinderheilkunde und Jugendmedizin, Mathildenstrasse 1, 79106 Freiburg. hentsch@kikli.ukl.uni-freiburg.de
Sutor
A H
AH
D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D013923:Thromboembolism / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control*