NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related venous thrombosis.
Research article published in Journal of thrombosis and haemostasis : JTH (2022)
Abstract
BACKGROUND: In critically ill (preterm) neonates, catheter-related venous thromboembolism (CVTE) can be a life-threatening complication. Evidence on optimal management in the literature is lacking. In the Netherlands, a consensus-based national management guideline was developed to create uniform CVTE management. OBJECTIVES: To evaluate the efficacy and safety of the national guideline. METHODS: This prospective, multicenter, observational study included all infants aged ≤6 months with CVTE in the Netherlands between 2014 and 2019. CVTE was divided into thrombosis in veins and that in the right atrium, with their own treatment algorithms. The primary outcomes were recurrent venous thrombotic events (VTEs) and/or death due to CVTE as well as major bleeding. RESULTS: Overall, 115 neonates were included (62% male; 79% preterm). The estimated incidence of CVTE was 4.0 per 1000 neonatal intensive care unit admissions. Recurrent thrombosis occurred in 2 (1.7%) infants and death due to CVTE in 1 (0.9%) infant. Major bleeding developed in 9 (7.8%) infants: 2 of 7 (29%) on recombinant tissue plasminogen activator, which was given for high-risk right-atrium thrombosis, and 7 of 63 (11%) on low-molecular-weight heparin (LMWH). Five of the 7 bleedings because of LMWH were complications of subcutaneous catheter use for LMWH administration. CONCLUSION: The management of neonatal CVTE according to the Dutch CVTE management guideline led to a low incidence of recurrent VTEs and death due to VTEs. Major bleeding occurred in 7.8% of the infants. Specific guideline adjustments may improve efficacy and, especially, safety of CVTE management in neonates.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
In critically ill (preterm) neonates, catheter-related venous thromboembolism (CVTE) can be a life-threatening complication. Evidence on optimal management in the literature is lacking.
Por qué esto importa para la hirudoterapia
Este estudio prospectivo, multicéntrico y observacional evaluó una guía nacional para el manejo de la trombosis venosa relacionada con catéteres en neonatos, encontrando una baja incidencia de trombosis recurrente y mortalidad, aunque el sangrado mayor ocurrió en el 7,8 % de los lactantes, asociado principalmente con la administración de heparina de bajo peso molecular. El estudio examina la seguridad y la eficacia de las intervenciones anticoagulantes y fibrinolíticas sistémicas en una población altamente vulnerable. Si bien los componentes del secretoma de la sanguijuela poseen propiedades anticoagulantes, el enfoque de este estudio en la trombosis sistémica neonatal asociada a catéteres centrales prácticamente no presenta solapamiento clínico con la hirudoterapia externa. Por lo tanto, el estudio carece de relevancia directa para la American Society of Hirudotherapy.
Citación
NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related venous thrombosis.
van Ommen et al. · Journal of thrombosis and haemostasis : JTH, 2022
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026