BACKGROUND The incidence of central venous catheter-related thrombosis and the long-term effects of thrombosis on catheterized veins in neonates is unknown. We therefore determined the incidence of central venous thrombosis, identified associated risk factors, and evaluated outcomes at 6 months. METHODS We enrolled neonates aged less than 28 days scheduled for major intestinal or cardiac surgery whom we expected to require central venous catheters for at least 48 hours. Catheter size, insertion method, and puncture site were determined by the attending anesthesiologist. The duration of catheterization was also determined by clinical need. Central venous thrombi were diagnosed by color Doppler ultrasound imaging within 48 hours after catheter removal; results were not shared with clinicians. Ultrasound examinations were repeated 1, 3, and 6 months after discharge. RESULTS We enrolled 188 neonates over 2 years. The median duration of catheter insertion was 12 days. 128 (68%) of the neonates had central venous thrombi at the catheter site, all of which were asymptomatic. Among patients with thrombi, 29 (23%) had complete vessel occlusion and 5 (4%) had venous stenosis at 6 months after discharge. Thrombi therefore spontaneously resolved by 6 months in 73% of the neonates. CVC/vein diameter ratio, duration of catheterization, and catheter dysfunction were independent risk factors for vessel thrombus. Complete vessel occlusion was most common in patients whose thrombus occupied more than 58% of the vessel at the initial assessment. CONCLUSIONS Covert central venous thrombosis is frequent in neonates who have central venous catheters, and complications are most common in patients who have large intravascular thrombi. Neonates with large intravascular thrombi should be followed, and considered for anticoagulation.

中文翻译：

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新生儿导管相关颈内静脉血栓形成及其长期后果：一项前瞻性队列研究。


背景 中心静脉导管相关血栓形成的发生率以及血栓形成对新生儿插管静脉的长期影响尚不清楚。因此，我们确定了中心静脉血栓形成的发生率，确定了相关危险因素，并评估了 6 个月时的结果。方法 我们招募了 28 天以下的新生儿，计划进行重大肠道或心脏手术，我们预计这些新生儿需要中心静脉导管至少 48 小时。导管尺寸、插入方法和穿刺部位由主治麻醉师决定。导管插入的持续时间也根据临床需要确定。拔除导管后48小时内通过彩色多普勒超声诊断中心静脉血栓；结果未与临床医生分享。出院后1、3、6个月重复超声检查。结果 我们在 2 年内招募了 188 名新生儿。导管插入的中位持续时间为 12 天。 128 名（68%）新生儿在导管部位出现中心静脉血栓，但均无症状。出院后 6 个月，血栓患者中，29 例（23%）出现血管完全闭塞，5 例（4%）出现静脉狭窄。因此，73% 的新生儿血栓在 6 个月时自行消退。 CVC/静脉直径比、导管插入时间和导管功能障碍是血管血栓的独立危险因素。在初次评估时血栓占据血管超过 58% 的患者中，最常见的是完全血管闭塞。结论 隐性中心静脉血栓形成在有中心静脉导管的新生儿中很常见，而并发症最常见于有大血管内血栓的患者。 对有大血管内血栓的新生儿应进行随访，并考虑抗凝治疗。