Umbilical Catheter-Associated Portal Vein Thrombosis: A Center Experience

Year 2019, Volume: 16 Issue: 3, 501 - 504, 25.12.2019

Nilüfer Okur , Muhammet Asena Kıymet Çelik Nurettin Okur

https://doi.org/10.35440/hutfd.560646

Abstract

Background: Invasive procedures are increasingly used in neonatal intensive care
units. Umbilical catheters are frequently attached to preterm babies. The aim
of this study is to determine the relationship and risk factors of umbilical
catheters inserted in our clinic with portal vein thrombosis (PVT).

Materials and Methods: We retrospectively evaluated preterm infants
with a gestational age of 32 weeks and below, who had a umbilical vein catheter
(UVC) inserted in our neonatal intensive care unit between 01 October 2017 and
31 December 2018, and who had a catheter inserted for at least 6 hours. UVC
inserted cases were evaluated for portal venous doppler ultrasonograpy (USG)
examination before discharge. Perinatal risk factors and properties related to
catheter were evaluated.

Results:
A total of 142 patients underwent UVC insertion. Doppler USG results of 118
patients were achieved. In 15 (9.9%) cases, portal vein thrombosis was detected
by doppler USG. None of the patients with PVT had clinical findings. The mean
gestational age and birth weight were lower in patients with PVT. Thrombosis
was detected in the left branch of portal vein in 14 patients and thrombosis in
the main portal vein in one patient. In a patient with PVT, gestational
diabetes was present in the mother. Patients with PVT had higher rates of late
neonatal sepsis and bronchopulmonary dysplasia, and the length of
hospitalization was longer. In this group, the low placement rate of the
catheter was higher, and the length of catheter stay was longer than other
group.

Conclusions: Umbilical vein catheterization is an important risk factor for the
development of PVT. Especially low birth weight infants with UVC should be
evaluated with portal doppler USG for PVT.

Umblikal Kateter İlişkili Portal Ven Trombozu: Bir Merkez Deneyimi

Abstract

Amaç: Yenidoğan yoğun bakım ünitelerinde giderek artan sıklıkta invaziv
girişimler yapılmaktadır. Özellikle preterm bebeklere sıklıkla umblikal kateterler
takılmaktadır. Bu çalışmanın amacı kliniğimizde takılan umblikalkateterlerin
portal ventrombozu (PVT) ile ilişkisini ve risk faktörlerini
belirleyebilmektir.

Materyal ve
metod: Retrospektif olarak 01
Ekim 2017-31 Aralık 2018 tarihleri arasında kliniğimiz yenidoğan yoğun bakım
ünitesinde izlenen gestasyon yaşı 32 hafta ve altında olan, umblikal kateter
takılan ve en az 6 saat boyunca kateter takılı olan preterm bebekler çalışmaya
dahil edildi. Umblikal ven kateteri (UVK) takılan hastaların taburculuk öncesi
PVT açısından yapılan portal venöz doppler ultrasonografi (USG) sonuçları ile
perinatal risk faktörleri ve kateter ile ilgili özellikler değerlendirildi.

Bulgular: 142 hastaya UVK takıldı. 118 hastanın doppler USG sonucuna ulaşıldı. On
beş (%9,9) hastada doppler USG ile PVT saptandı. PVT saptanan hastaların
hiçbirinde klinik bulgu yoktu. PVT saptanan hastaların ortalama gestasyon yaşı
ve doğum ağırlığı, PVT saptanmayan hastalardan daha düşüktü. On dört hastada
portal venin sol dalında tromboz saptanırken, bir hastada ana portal vende tromboz
saptandı.Tromboz saptanan bir hastada annede gestasyonel diyabet mevcuttu. PVT
saptanan hastaların geç neonatal sepsis ve bronkopulmoner displazi oranları
daha yüksekti, hastanede yatış süresi daha uzundu. Yine bu grupta kateterin
alçak yerleşim oranı daha fazla, kateter kalış süresi ise diğer gruba göre daha
uzundu.

Sonuç: Umblikal ven kateterizasyonu PVT gelişimi için önemli bir risk
faktörüdür. UVK takılan, özellikle düşük doğum ağırlıklı hastalar PVT açısından
portal doppler USG ile değerlendirilmelidir.

Keywords

portal ven, preterm

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