ABSTRACT
Objective:To study the clinical characteristics of neonatal umbilical vascular catheter (UVC) rupture.Methods:A neonate with UVC rupture admitted to Neonatology Department of our hospital was retrospectively reviewed. Literature on this subject were searched in the following databases: Chinese Medical Journal full-text Database, CNKI, Wanfang Database, CQVIP database, PubMed, Web of Science, Embase and Cochrane Library (up until March 15 2022). The causes, treatment and prognosis of neonatal UVC rupture were analyzed.Results:In our case, the UVC was accidentally damaged during the removal of the ligature suture. The UVC was ruptured after a slight force was applied to remove the catheter, resulting in approximately 7 cm of UVC remaining in the body. Trans-umbilical vein intervention was performed and the catheter was successfully removed with a lasso under X-ray guidance. A total of 33 UVC rupture cases were included from 15 articles (no case report in China before). In 16 cases (47.1%), the UVCs were accidentally cut off by knife or scissors when removing the catheter. In 3 cases (8.8%), the UVCs were broken during insertion. The UVC was broken in 1 case (2.9%) during flushing the catheter. The causes of the other 14 cases (41.2%) were unknown. 9 cases (26.5%) had clinical manifestations, including respiratory distress, prominent heart murmur, sepsis and limb ischemia. 20 cases (58.8%) showed no clinical features. No data on the other 5 cases (14.7%). 21 cases (61.8%) received vascular intervention removal, 11 cases (32.4%) received surgical removal, 1 case (2.9%) was removed with tweezers, and 1 case (2.9%) died before UVC was removed. Among the neonates receiving surgical treatment, 1 case died of sepsis on the second day after surgery and 1 case had sequela of limb ischemia. 2 cases had postoperative vasospasm and embolism after vascular intervention with overall good prognosis.Conclusions:The rupture of UVC in neonates is rare and mainly related with knife and scissors injury.
ABSTRACT
Objective@#To explore the characteristics of thrombelastogaphy (TEG) in term neonates, and to evaluate their correlation with traditional coagulation tests.@*Methods@#A total of 52 term neonates were enrolled as neonatal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017.TEG, plasma coagulation test and platelet counts (PLT) were performed and the corresponding ana-lysis was conducted.@*Results@#TEG parameters in term neonates: response time(R)(4.18±1.08)min, clot kinetics(K)(1.21±0.45) min, α angle (Angle)(73.08±5.74)°, maximum amplitude(MA)(65.68±7.13)mm.Compared with adult control group, neonatal group exhibited shorter R and K(t=3.764, P<0.001; t=4.888, P<0.001), higher Angle, MA(t=5.539, P<0.001; t=2.873, P=0.001). In traditional coagulation, compared with adult control group, neonatal group showed longer prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) (t=5.449, P<0.001; t=13.134, P<0.001; t=3.575, P=0.001), lower fibrinogen(Fib) (t=4.164, P<0.001), and higher PLT (t=4.230, P<0.001). In addition, K was negatively correlated with Fib(r=-0.374, P=0.004), while Angle and MA were positively correlated with Fib(r=0.354, P=0.007; r=0.630, P<0.001); K was negatively correlated with PLT(r=-0.430, P=0.001), but Angle and MA were positively correlated with PLT (r=0.427, P=0.001; r=0.586, P<0.001); K was positively correlated with APTT(r=0.285, P=0.035), and MA was negatively correlated with APTT(r=-0.324, P=0.017). There was no significant correlation between R and traditional coagulation test.K, MA and Angle were not significantly correlated with PT (all P>0.05), and Angle and APTT were not significantly correlated (all P>0.05).@*Conclusions@#The reference interval of TEG in term neonates is different from adults.And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.
ABSTRACT
Objective To explore the characteristics of thrombelastogaphy( TEG)in term neonates,and to evaluate their correlation with traditional coagulation tests. Methods A total of 52 term neonates were enrolled as neo-natal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017. TEG,plasma coagulation test and platelet counts(PLT)were performed and the corresponding ana-lysis was conducted. Results TEG parameters in term neonates:response time(R)(4. 18 ± 1. 08)min,clot kinetics (K)(1. 21 ± 0. 45)min,α angle( Angle)(73. 08 ± 5. 74)°,maximum amplitude( MA)(65. 68 ± 7. 13)mm. Com-pared with adult control group,neonatal group exhibited shorter R and K(t=3. 764,P<0. 001;t=4. 888,P<0. 001), higher Angle,MA(t=5. 539,P<0. 001;t=2. 873,P=0. 001). In traditional coagulation,compared with adult control group,neonatal group showed longer prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time(TT)(t=5. 449,P<0. 001;t=13. 134,P<0. 001;t=3. 575,P=0. 001),lower fibrinogen( Fib)(t=4. 164, P<0. 001),and higher PLT(t=4. 230,P<0. 001). In addition,K was negatively correlated with Fib(r= -0. 374, P=0. 004),while Angle and MA were positively correlated with Fib(r=0. 354,P=0. 007;r=0. 630,P<0. 001);K was negatively correlated with PLT(r= -0. 430,P=0. 001),but Angle and MA were positively correlated with PLT (r=0. 427,P=0. 001;r=0. 586,P<0. 001);K was positively correlated with APTT(r=0. 285,P=0. 035),and MA was negatively correlated with APTT(r= -0. 324,P=0. 017). There was no significant correlation between R and tra-ditional coagulation test. K,MA and Angle were not significantly correlated with PT(all P >0. 05),and Angle and APTT were not significantly correlated(all P>0. 05). Conclusions The reference interval of TEG in term neonates is different from adults. And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.