Assessment of Incidence and Risk Factors of Umbilical Catheter Associated Thrombosis in Newborn Infants Using Color Doppler

Umbilical vascular catheters are routinely inserted in critically ill newborn infants in most neonatal intensive care units (NICU). This study aims at assessing the incidence and risk factors of umbilical catheter associated thrombosis in newborn infants using color Doppler. In a cross-sectional analytic-descriptive study, 256 newborn infants with umbilical catheters were evaluated in Tabriz Children Hospital during a 15-month period. Color Doppler ultrasonography was employed for detection of vascular thrombosis associated with the umbilical catheter placement in the first 24-48 hours after admission, weekly until discharge and 72 hours after discharge. Accordingly, the patients categorized into two groups; those with or without thrombosis and possible risk factors were investigated. Among 256 newborns, 12 cases (4.7%) had vascular thrombosis. One hundred and forty four catheters were placed in umbilical artery, 35 catheters in umbilical vein and 77 catheters in umbilical artery and vein. The rate of thrombosis was 6.9 and 5.7% in the umbilical artery and vein catheters, respectively. There was no significant relation between sex, birth weight, delivery age, type and size of catheter, location of catheterization, underlying disease and type of administered drugs with thrombosis formation. The only significant risk factor was duration of the catheterization (5.3 days in thrombosis vs. 3.3 days in non-thrombosis groups; P=0.005). In 75% of the cases, thrombosis was detected 72 hours after extraction of catheters. Prolonged duration of the umbilical catheters is accompanied with increased risk of thrombosis. Assessment of the patient by color Doppler ultrasonography is recommended after extraction of the catheters.