NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related venous thrombosis.

Autor:	van Ommen CH; Department of Pediatric Hematology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: c.vanommen@erasmusmc.nl., Bergman KA; Department of Neonatology, University Medical Centre Groningen, Beatrix Children's Hospital, Groningen, The Netherlands., Boerma M; Erasmus University Medical Centre, Rotterdam, The Netherlands., Bouma HA; Department of Neonatology, University Medical Centre Groningen, Beatrix Children's Hospital, Groningen, The Netherlands., Donker AE; Department of Pediatrics, Máxima Medical Centre, Veldhoven, The Netherlands., Gouvernante M; Faculty of Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., Hulzebos CV; Department of Neonatology, University Medical Centre Groningen, Beatrix Children's Hospital, Groningen, The Netherlands., Khandour D; Faculty of Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., Knol R; Department of Neonatology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands., Raets MA; Department of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands., Liem KD; Department of Neonatology, Radboud University Medical Centre, Nijmegen, The Netherlands., van Lingen RA; Department of Neonatology, Isala Hospital, Zwolle, The Netherlands., van de Loo M; Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands., Lopriore E; Department of Pediatrics, Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands., van der Putten M; Department of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands., Sol JJ; Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, The Netherlands., Suijker MH; Department of Pediatric Hematology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands., Vijlbrief DC; Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands., Visser R; Department of Pediatrics, Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands., van Weissenbruch MM; Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical Center, VU Medical Center, VU University, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2023 Apr; Vol. 21 (4), pp. 963-974. Date of Electronic Publication: 2022 Dec 22.
DOI:	10.1016/j.jtha.2022.11.044
Abstrakt:	Background: In critically ill (preterm) neonates, catheter-related venous thromboembolism (CVTE) can be a life-threatening complication. Evidence on optimal management in the literature is lacking. In the Netherlands, a consensus-based national management guideline was developed to create uniform CVTE management. Objectives: To evaluate the efficacy and safety of the national guideline. Methods: This prospective, multicenter, observational study included all infants aged ≤6 months with CVTE in the Netherlands between 2014 and 2019. CVTE was divided into thrombosis in veins and that in the right atrium, with their own treatment algorithms. The primary outcomes were recurrent venous thrombotic events (VTEs) and/or death due to CVTE as well as major bleeding. Results: Overall, 115 neonates were included (62% male; 79% preterm). The estimated incidence of CVTE was 4.0 per 1000 neonatal intensive care unit admissions. Recurrent thrombosis occurred in 2 (1.7%) infants and death due to CVTE in 1 (0.9%) infant. Major bleeding developed in 9 (7.8%) infants: 2 of 7 (29%) on recombinant tissue plasminogen activator, which was given for high-risk right-atrium thrombosis, and 7 of 63 (11%) on low-molecular-weight heparin (LMWH). Five of the 7 bleedings because of LMWH were complications of subcutaneous catheter use for LMWH administration. Conclusion: The management of neonatal CVTE according to the Dutch CVTE management guideline led to a low incidence of recurrent VTEs and death due to VTEs. Major bleeding occurred in 7.8% of the infants. Specific guideline adjustments may improve efficacy and, especially, safety of CVTE management in neonates. Competing Interests: Declaration of competing interests C.H.v.O. reports consulting fees paid to the department from Bayer BV, Boehringer Ingelheim, and Daiichi Sankyo; lecture honoraria paid to the department from Boehringer Ingelheim; and an unrestricted grant paid to the department from Octapharma, all outside the submitted work. (Copyright © 2022 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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