Central venous thrombosis in children with intestinal failure on long-term parenteral nutrition
| Autor: | Jennifer Styers, Hannah G. Piper, Nandini Channabasappa, Janna M. Journeycake, Jessica Gonzalez-Hernandez, Yahya Daoud |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Catheterization Central Venous medicine.drug_class medicine.medical_treatment Thrombophilia Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics Internal medicine medicine Humans Vein Child Retrospective Studies Venous Thrombosis business.industry Incidence Anticoagulant Infant Newborn Infant General Medicine medicine.disease Thrombosis Surgery Venous thrombosis Intestinal Diseases medicine.anatomical_structure Parenteral nutrition Child Preschool Pediatrics Perinatology and Child Health 030211 gastroenterology & hepatology Female Liver function business Parenteral Nutrition Home Central venous catheter |
| Zdroj: | Journal of pediatric surgery. 51(5) |
| ISSN: | 1531-5037 |
| Popis: | Purpose Central venous thrombosis (CVT) is a serious complication of long-term central venous access for parenteral nutrition (PN) in children with intestinal failure (IF). We reviewed thse incidence of CVT and possible risk factors. Methods Children with IF on home PN (2010–2014) with central venous imaging were reviewed. Patient demographics, catheter characteristics and related complications, and markers of liver function were compared between children with and without CVT. Serum thrombophilia markers were reviewed for patients with CVT. Results Thirty children with central venous imaging were included. Seventeen patients had thrombosis of ≥1 central vein, and twelve had ≥2 thrombosed central veins. Patients with and without CVT had similar demographics and catheter characteristics. Patients with CVT had a significantly lower albumin level (2.76±0.38g/dL vs. 3.12±0.41g/dL, p=0.0223). The most common markers of thrombophilia in children with CVT were antithrombin, protein C and S deficiencies, and elevated factor VIII. There was a statistically significant correlation between a combined protein C and S deficiency and having >1 CVT. Conclusions Children with IF on long-term PN are at high risk for CVT potentially owing to low levels of natural anticoagulant proteins and elevated factor FVIII activity, likely a reflection of liver insufficiency and chronic inflammation. |
| Databáze: | OpenAIRE |
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