Incidence of umbilical vein catheter-associated thrombosis of the portal system: A systematic review and meta-analysis.

Hepatic thrombosis Incidence Neonate Portal system thrombosis Portal vein thrombosis Umbilical venous catheter

Journal

World journal of hepatology
ISSN: 1948-5182
Titre abrégé: World J Hepatol
Pays: United States
ID NLM: 101532469

Informations de publication

Date de publication:
27 Nov 2021
Historique:
received: 21 03 2021
revised: 31 08 2021
accepted: 14 10 2021
entrez: 14 12 2021
pubmed: 15 12 2021
medline: 15 12 2021
Statut: ppublish

Résumé

The use of umbilical venous catheters (UVCs) in the perinatal period may be associated with severe complications, including the occurrence of portal vein thrombosis (PVT). To assess the incidence of UVC-related PVT in infants with postnatal age up to three months. A systematic and comprehensive database searching (PubMed, Cochrane Library, Scopus, Web of Science) was performed for studies from 1980 to 2020 (the search was last updated on November 28, 2020). We included in the final analyses all peer-reviewed prospective cohort studies, retrospective cohort studies and case-control studies. The reference lists of included articles were hand-searched to identify additional studies of interest. Studies were considered eligible when they included infants with postnatal age up to three months with UVC-associated PVT. Incidence estimates were pooled by using random effects meta-analyses. The quality of included studies was assessed using the Newcastle-Ottawa scale. The systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Overall, 16 studies were considered eligible and included in the final analyses. The data confirmed the relevant risk of UVC-related thrombosis. The mean pooled incidence of such condition was 12%, although it varied across studies (0%-49%). In 15/16 studies (94%), diagnosis of thrombosis was made accidentally during routine screening controls, whilst in 1/16 study (6%) targeted imaging assessments were carried out in neonates with clinical concerns for a thrombus. Tip position was investigated by abdominal ultrasound (US) alone in 1/16 (6%) studies, by a combination of radiography and abdominal US in 14/16 (88%) studies and by a combination of radiography, abdominal US and echocardiography in 1/16 (6%) studies. To the best of our knowledge, this is the first systematic review specifically investigating the incidence of UVC-related PVT. The use of UVCs requires a high index of suspicion, because its use is significantly associated with PVT. Well-designed prospective studies are required to assess the optimal approach to prevent UVC-related thrombosis of the portal system.

Sections du résumé

BACKGROUND BACKGROUND
The use of umbilical venous catheters (UVCs) in the perinatal period may be associated with severe complications, including the occurrence of portal vein thrombosis (PVT).
AIM OBJECTIVE
To assess the incidence of UVC-related PVT in infants with postnatal age up to three months.
METHODS METHODS
A systematic and comprehensive database searching (PubMed, Cochrane Library, Scopus, Web of Science) was performed for studies from 1980 to 2020 (the search was last updated on November 28, 2020). We included in the final analyses all peer-reviewed prospective cohort studies, retrospective cohort studies and case-control studies. The reference lists of included articles were hand-searched to identify additional studies of interest. Studies were considered eligible when they included infants with postnatal age up to three months with UVC-associated PVT. Incidence estimates were pooled by using random effects meta-analyses. The quality of included studies was assessed using the Newcastle-Ottawa scale. The systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines.
RESULTS RESULTS
Overall, 16 studies were considered eligible and included in the final analyses. The data confirmed the relevant risk of UVC-related thrombosis. The mean pooled incidence of such condition was 12%, although it varied across studies (0%-49%). In 15/16 studies (94%), diagnosis of thrombosis was made accidentally during routine screening controls, whilst in 1/16 study (6%) targeted imaging assessments were carried out in neonates with clinical concerns for a thrombus. Tip position was investigated by abdominal ultrasound (US) alone in 1/16 (6%) studies, by a combination of radiography and abdominal US in 14/16 (88%) studies and by a combination of radiography, abdominal US and echocardiography in 1/16 (6%) studies.
CONCLUSION CONCLUSIONS
To the best of our knowledge, this is the first systematic review specifically investigating the incidence of UVC-related PVT. The use of UVCs requires a high index of suspicion, because its use is significantly associated with PVT. Well-designed prospective studies are required to assess the optimal approach to prevent UVC-related thrombosis of the portal system.

Identifiants

pubmed: 34904047
doi: 10.4254/wjh.v13.i11.1802
pmc: PMC8637679
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1802-1815

Informations de copyright

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: The authors have no conflict of interest to declare.

Références

J Pediatr (Rio J). 2017 Mar - Apr;93(2):172-178
pubmed: 27424226
Cochrane Database Syst Rev. 2017 Oct 10;10:CD012142
pubmed: 29017005
Semin Thromb Hemost. 2011 Oct;37(7):763-1
pubmed: 22187399
Eur J Anaesthesiol. 1984 Dec;1(4):361-5
pubmed: 6536520
Pediatrics. 1995 Nov;96(5 Pt 1):939-43
pubmed: 7478839
Neonatology. 2017;111(4):337-343
pubmed: 28092913
Br J Haematol. 2011 Jul;154(2):196-207
pubmed: 21595646
J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):599-604
pubmed: 22684349
Thromb Res. 2020 Oct;194:21-25
pubmed: 32563060
Thromb Haemost. 1995 Feb;73(2):180-5
pubmed: 7792727
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
Ann Trop Paediatr. 2009 Dec;29(4):271-9
pubmed: 19941750
Indian J Pediatr. 2009 Dec;76(12):1268-9
pubmed: 20012786
Eur Radiol. 2011 Sep;21(9):1882-6
pubmed: 21533866
Antimicrob Agents Chemother. 2018 Nov 26;62(12):
pubmed: 30224526
Pediatr Radiol. 2014 Jul;44(7):810-5
pubmed: 24557484
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Pediatr Radiol. 2018 Dec;48(13):1964-1970
pubmed: 30078110
J Perinatol. 2020 Apr;40(4):573-580
pubmed: 31911645
Semin Fetal Neonatal Med. 2006 Jun;11(3):198-206
pubmed: 16520103
Singapore Med J. 2021 Jan;62(1):29-33
pubmed: 33619572
J Pediatr Gastroenterol Nutr. 1993 Nov;17(4):392-6
pubmed: 8145094
J Paediatr Child Health. 2018 Dec;54(12):1329-1335
pubmed: 29806878
Pediatr Blood Cancer. 2009 Jan;52(1):75-9
pubmed: 18680150
J Pediatr. 1997 Nov;131(5):760-2
pubmed: 9403662
Turk Pediatri Ars. 2020 Sep 23;55(3):257-262
pubmed: 33061753
Pediatr Blood Cancer. 2019 Apr;66(4):e27572
pubmed: 30520242
J Ultrasound Med. 2020 Feb;39(2):379-383
pubmed: 31400014
J Pediatr. 1995 Apr;126(4):633-5
pubmed: 7699547
Neonatology. 2019;115(3):205-210
pubmed: 30645997
Trop Gastroenterol. 2007 Apr-Jun;28(2):79-80
pubmed: 18050847
J Pediatr. 2006 Jun;148(6):735-9
pubmed: 16769378
AJR Am J Roentgenol. 2003 Apr;180(4):1147-53
pubmed: 12646473
Acta Haematol. 2007;117(3):149-55
pubmed: 17159337
Radiology. 2001 Jun;219(3):645-50
pubmed: 11376248
J Matern Fetal Neonatal Med. 2019 Jul;32(14):2429-2437
pubmed: 29397784
Am J Perinatol. 2019 Nov;36(13):1377-1381
pubmed: 30620943
J Perinatol. 2018 Oct;38(10):1359-1364
pubmed: 30082773
Indian J Gastroenterol. 2007 Nov-Dec;26(6):283-4
pubmed: 18431012
Arch Dis Child Fetal Neonatal Ed. 2020 May;105(3):299-303
pubmed: 31391204
Thromb Res. 2018 Aug;168:80-82
pubmed: 29936402
J Pediatr Surg. 2013 Oct;48(10):2067-74
pubmed: 24094959
Am J Perinatol. 2014 Nov;31(11):965-74
pubmed: 24590868
Indian J Pediatr. 2011 Feb;78(2):161-4
pubmed: 21063811
Pediatr Int. 2015 Jun;57(3):478-80
pubmed: 26011554
Pediatrics. 2006 Jul;118(1):e25-35
pubmed: 16785289
Arch Dis Child Fetal Neonatal Ed. 2017 May;102(3):F251-F255
pubmed: 28424358
J Perinatol. 2007 Aug;27(8):490-5
pubmed: 17625574
Blood Coagul Fibrinolysis. 2014 Mar;25(2):97-106
pubmed: 24477225
Chest. 2012 Feb;141(2 Suppl):e737S-e801S
pubmed: 22315277
Semin Fetal Neonatal Med. 2011 Dec;16(6):340-4
pubmed: 21807572
Semin Fetal Neonatal Med. 2011 Dec;16(6):329-39
pubmed: 21925985
J Ultrasound Med. 2016 Jul;35(7):1465-73
pubmed: 27229130
BMJ Case Rep. 2016 Feb 03;2016:
pubmed: 26843419
Pediatr Crit Care Med. 2012 Sep;13(5):549-53
pubmed: 22805159
J Perinatol. 2003 Jan;23(1):24-8
pubmed: 12556923
Am J Infect Control. 2011 May;39(4 Suppl 1):S1-34
pubmed: 21511081
Thromb Res. 2012 Nov;130(5):725-8
pubmed: 22901699
J Paediatr Child Health. 1999 Oct;35(5):460-5
pubmed: 10571759
J Matern Fetal Neonatal Med. 2016 Sep;29(17):2817-22
pubmed: 26452458
Resuscitation. 2012 Jun;83(6):705-9
pubmed: 22155219
J Pediatr Surg. 2008 May;43(5):E39-41
pubmed: 18485935
Blood. 2018 Jun 14;131(24):2712-2719
pubmed: 29724900
Am J Perinatol. 2019 Sep;36(11):1198-1204
pubmed: 30566998
J Ultrasound Med. 2018 Jun;37(6):1335-1344
pubmed: 29034490
Dig Liver Dis. 2019 Aug;51(8):1179-1184
pubmed: 30928422
Br J Haematol. 2000 Nov;111(2):534-9
pubmed: 11122096
Pediatr Neonatol. 2020 Feb;61(1):16-24
pubmed: 31186169
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120

Auteurs

Iliana Bersani (I)

Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy.

Fiammetta Piersigilli (F)

Department of Neonatology, Cliniques Universitaires Saint Luc, Universitè Catholique de Louvain, Bruxelles 1200, Belgium.

Giulia Iacona (G)

Faculty of Medicine, Imperial College London, London SW7 2AZ, United Kingdom.

Immacolata Savarese (I)

Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy.

Francesca Campi (F)

Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy.

Andrea Dotta (A)

Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy.

Cinzia Auriti (C)

Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy.

Enrico Di Stasio (E)

Department of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma 00168, Italy. enrico.distasio@unicatt.it.

Matteo Garcovich (M)

CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy.

Classifications MeSH