Heparin infusion to prevent umbilical venous catheter related thrombosis in neonates.
OBJECTIVE
To investigate umbilical venous catheter (UVC) related thrombosis by Doppler echocardiographic evaluation of neonates infused with heparin or placebo.


METHODS
We conducted a prospective study to determine UVC-related thrombosis in term and nearterm neonates. Heparin or placebo (0.5 IU/mL) was infused at a rate of 1 mL/hr to the study and control group. Doppler echocardiography was performed at 1, 3, and 5 days after UVC insertion.


RESULTS
Forty-six neonates (63% males) with a mean gestational age of 38.2 ± 1.8 weeks, and a mean birth-weight of 2993 ± 563 grams were included. No UVC-related thrombosis was observed in the study group, which included 19 neonates. Among the 27 neonates in the control group, one neonate developed UVC-related thrombosis. There were no statistical differences between the groups for gestational age, birth weight, postnatal age, UVC duration, mortality, mechanical ventilation, and inotrope requirement, and hemagram or coagulation profile. The complications were as follows, mild pulmonary hemorrhage, 6.5% (3); leak-out, 4.3% (2); peritoneal leakage, 2.2% (1); occlusion, 2.2% (1); gastrointestinal findings, 6.5% (3); sepsis, 10.9% (5); and catheter-related thrombosis, 2.2% (1).


CONCLUSIONS
This study demonstrated that heparin infusion of 0.5 IU/mL through the UVC had no effect on catheter-related thrombosis in term and near-term neonates. Randomized controlled trials are necessary to conclusively evaluate the effect of heparin on UVC-related thrombosis.
Division of Neonatology, Ankara Child Health, Hematology, Oncology, Research Hospital, Ankara, Turkey. sevimunal@yahoo.com
Sevim
S
Unal
Filiz
F
Ekici
İbrahim İlker
İİ
Cetin
Leyla
L
Bilgin
D000925:Anticoagulants / Q000008:administration & dosage*; D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*; D014471:Umbilical Veins
D000925:Anticoagulants; D006493:Heparin