Trombosis asociada a catéter venoso central neonatal: revisión narrativa de la bibliografía

Camilo Ruiz Mejía, Laura Isabel Jaramillo Jaramillo, Lina María Martínez Sánchez, Juan Diego Villegas Álzate, Luis Felipe Álvarez Hernández, Luz Natalia Builes Restrepo

Resumen


ANTECEDENTES: La aplicación de un catéter venoso central es una medida indispensable en las unidades de cuidados intensivos neonatales. Su uso se asocia con riesgo de trombosis, que es la causa principal de esta complicación en los neonatos.

OBJETIVO: Efectuar una revisión narrativa de la evidencia actual y la información disponible acerca de esta complicación, e identificar posibles focos de información para futuras investigaciones.

METODOLOGÍA: Búsqueda en diferentes bases de datos con los descriptores: coagulación sanguínea, trombosis, embolia y catéteres publicados en español e inglés. Se seleccionaron 36 artículos.

RESULTADOS: La trombosis asociada al catéter venoso central es una complicación vinculada con la colocación de un catéter en el lumen vascular. La incidencia y prevalencia mundial de esta complicación en neonatos ha sido poco estudiada debido, en parte, a la dificultad para estimar la gravedad del problema. Por lo general, los signos y síntomas dependen de la localización del trombo, a pesar de la variabilidad en el cuadro clínico y que la mayor parte de los trombos asociados con un catéter venoso central son silentes. Para el tratamiento se indican fibrinolíticos (urocinasa y la alteplasa).

CONCLUSIONES: Las complicaciones derivadas de la aplicación de catéteres venosos centrales, a pesar de ser una técnica común, no se han estudiado del todo y por eso su tratamiento en los neonatos no está estandarizado.

 


Texto completo:

PDF

Referencias


Van Ommen CH, Sol JJ. Developmental Hemostasis and Management of Central Venous Catheter Thrombosis in Neonates. Semin Thromb Hemost. 2016;42(7):752-9. DOI: 10.1055/s-0036-1592299.

Haddad H, Lee KS, Higgins A, McMillian D, Price V, El-Naggar W. Routine Surveillance Ultrasound for the Management of Central Venous Catheters in Neonates. J Pediatr 2014; 164(1):118-22. DOI: 10.1016/j.jpeds.2013.08.048.

Park CK, Paes BA, Nagel K, Chan AK, Murthy P. Neonatal central venous catheter thrombosis: diagnosis, management and outcome. Blood Coagul Fibrinol. 2014;25:97–106. DOI: 10.1097/MBC.0b013e328364f9b0.

Sellitto M, Messina F. Central venous catheterization and thrombosis in newborns: update on diagnosis and management. J Matern Fetal Neonatal Med. 2012; 25(S4): 26–8. 10.3109/14767058.2012.714974.

Palis J, Segel GB. Hematology of the Fetus and Newborn. In: Kaushansky K, Lichtman MA, Prchal JT, Levi MM, Press OW, Burns LJ, Caligiuri M. eds. Williams Hematology, 9e New York, NY: McGraw-Hill;

Vidal E, Sharathkumar A, Glover J, Faustino EVS. Central venous catheter-related thrombosis and thromboprophylaxis in children: a systematic review and meta-analysis. J Thromb Haemost. 2014;12(7):1096–109. DOI: 10.1111/jth.12773.

Bacciedoni V, Attie M, Donato H. Thrombosis in newborn infants. Arch Argent Pediatr. 2016;114(2):159-66.

Giordano P, Saracco P, Grassi M, Luciani M, Banov L, Carraro F, et al. Recommendations for the use of long-term central venous catheter (CVC) in children with hemato-oncological disorders: management of CVC-related occlusion and CVC-related thrombosis. On behalf of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Ann Hematol. 2015;94(11):1765–76. DOI: 10.1007/s00277-015-2481-1.

Nifong TP, McDevitt TJ. The Effect of Catheter to Vein Ratio on Blood Flow Rates in a Simulated Model of Peripherally Inserted Central Venous Catheters. Chest. 2011;140(1):48–53. DOI: 10.1378/chest.10-2637.

González FL, Lauria MJ. Determinación de valores de referencia para pruebas de coagulación en una población pediátrica. Acta Bioquím Clín Latinoam 2014; 48 (2): 237-41

Williams MD, Chalmers EA, Gibson BE; Haemostasis and Thrombosis Task Force, British Committee for Standards in Haematology. The investigation and management of neonatal haemostasis and thrombosis. Br J Haematol. 2002;119(2):295-309. DOI: 10.1046/j.1365-2141.2002.03674.x.

Saxonhouse M. Thrombosis in the Neonatal Intensive Care Unit. Clin Perinatol 2015; 42: 651–73. DOI: 10.1016/j.clp.2015.04.010.

Hanmod SS, Jesudas R, Kulkarni R, Chitlur M. Neonatal Hemostatic Disorders: Issues and Challenges. Semin Thromb Hemost. 2016;42(7):741-51. DOI: 10.1055/s-0036-1593415.

Saxonhouse MA, Burchfield DJ. The evaluation and management of postnatal thrombosis. J Perinatol. 2009;29(7):467-78. DOI: 10.1038/jp.2009.14.

Wu J, Mu D. Vascular catheter-related complications in newborns. J Paediatr Child Health. 2012;48(2):E91-5. DOI: 10.1111/j.1440-1754.2010.01934.x.

Manco M, Nuss R. Neonatal Thrombotic Disorders. NeoReviews. 2000; 1 (10):e201-05

Jaffray J, Bauman M, Massicotte P. The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism. Front Pediatr. 2017;5(5):1-6. DOI: 10.3389/fped.2017.00005.

Gominet M, Compain F, Beloin C, Lebeaux D. Central venous catheters and biofilms: where do we stand in 2017? APMIS. abril de 2017;125(4):365–75. DOI: 10.1111/apm.12665.

Horikawa M, Quencer KB. Central Venous Interventions. Tech Vasc Interv Radiol. marzo de 2017;20(1):48–57. DOI: 10.1053/j.tvir.2016.11.006.

Ullman AJ, Cooke ML, Mitchell M, Lin F, New K, Long DA, et al. Dressings and securement devices for central venous catheters (CVC). En: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2013.

Imigo G. F, Elgueta C. A, Castillo F. E, Celedón L. E, Fonfach Z. C, Lavanderos F. J, et al. Accesos venosos centrales. Cuad Cir. 2011;25(1):52–8.

Church JT, Jarboe MD. Vascular Access in the Pediatric Population. Surg Clin North Am. febrero de 2017;97(1):113–28. DOI: 10.1016/j.suc.2016.08.007.

Rosen BT, Wittnebel K. Chapter 115. Central Line Placement. In: McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. eds. Principles and Practice of Hospital Medicine New York, NY: McGraw-Hill; 2012.

Bhat S, Dahat A, Jain N, Nayak U, Patel V. Indications and complications of central venous catheterization in critically ill children in intensive care unit. Natl J Integr Res Med 2012;2(1):85-8.

Eisen LA. Mechanical Complications of Central Venous Catheters. J Intensive Care Med. el 1 de enero de 2006;21(1):40–6. DOI: 10.1177/0885066605280884.

Wilson TJ, Brown DL, Meurer WJ, Stetler WR, Wilkinson DA, Fletcher JJ. Risk factors associated with peripherally inserted central venous catheter-related large vein thrombosis in neurological intensive care patients. Intensive Care Med. febrero de 2012;38(2):272–8. DOI: 10.1007/s00134-011-2418-7.

Smitherman AB, Alexander T, Connelly M, Snavely AC, Weston BW, Liles EA, et al. The Incidence of Catheter-Associated Venous Thrombosis in Noncritically Ill Children. Hosp Pediatr. 2015;5(2):59–66. DOI: 10.1542/hpeds.2014-0041.

Schoot RA, van de Wetering MD, Stijnen T, Tissing WJ, Michiels E, Abbink FC, et al; DCOG-Aristocaths Supportive Care Working Group. Prevalence of Symptomatic and Asymptomatic Thrombosis in Pediatric Oncology Patients With Tunneled Central Venous Catheters. Pediatr Blood Cancer. 2016;63(8):1438-44. DOI: 10.1002/pbc.26036.

Beck C, Dubois J, Grignon A, Lacroix J, David M. Incidence and risk factors of catheter-related deep vein thrombosis in a pediatric intensive care unit: a prospective study. J Pediatr. 1998;133(2):237-41. DOI: 10.1016/s0022-3476(98)70226-4.

Karapinar B, Cura A. Complications of central venous catheterization in critically ill children. Pediatr Int. 2007;49(5):593-9. DOI: 10.1111/j.1442-200X.2007.02407.x.

Raffini L, Huang YS, Witmer C, Feudtner C. Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007. Pediatrics. 2009;124(4):1001-8. DOI: 10.1542/peds.2009-0768.

Fallouh N, McGuirk HM, Flanders SA, Chopra V. Peripherally Inserted Central Catheter-associated Deep Vein Thrombosis: A Narrative Review. Am J Med. 2015;128(7):722–38. DOI: 10.1016/j.amjmed.2015.01.027.

Saracco P, Bagna R, Gentilomo C, Magarotto M, Viano A, Magnetti F, et al. Clinical Data of Neonatal Systemic Thrombosis. J Pediatr. abril de 2016;171:60–6.e1. DOI: 10.1016/j.jpeds.2015.12.035.

Sol JJ, Knoester H, de Neef M, Smets AMJB, Betlem A, van Ommen CH. Chronic Complications After Femoral Central Venous Catheter-related Thrombosis in Critically Ill Children. J Pediatr Hematol Oncol. 2015;37(6):462–7. DOI: 10.1097/MPH.0000000000000370.

Debourdeau P, Farge D, Beckers M, Baglin C, Bauersachs RM, Brenner B, et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer: International guidelines on catheter-related thrombosis. J Thromb Haemost. 2013 Jan;11(1):71–80. DOI: 10.1111/jth.12071.

De Lorenzo-Pinto A, Sánchez-Galindo AC, Manrique-Rodríguez S, Fernández-Llamazares CM, Fernández-Lafever SN, San-Prudencio MG, et al. Prevention and treatment of intraluminal catheter thrombosis in children hospitalised in a paediatric intensive care unit. J Paediatr Child Health. 2014;50(1):40-6. DOI: 10.1111/jpc.12404.

Bracho-Blanchet E, Cortés-Sauza J, Dávila-Pérez R, Lezama-Del Valle P, Villalobos-Alfaro C, Nieto-Zermeño J. Usefulness of intravenous heparin to prevent thrombosis of central venous catheter in children. Cir Cir. 2010;78(5):423-9.

Cortejoso L, Manrique-Rodríguez S, Fernández-Llamazares CM, Sanjurjo-Sáez M. Treatment and prophylaxis of catheter-related thromboembolic events in children. J Pharm Pharm Sci. 2012;15(5):632-41.

Gasior AC, Marty Knott E, St Peter SD. Management of peripherally inserted central catheter ssociated deep vein thrombosis in children. Pediatr Surg Int. 2013;29(5):445-9. DOI: 10.1007/s00383-013-3259-y.

Davies GA, Lazo-Langner A, Gandara E, Rodger M, Tagalakis V, Louzada M, et al. A prospective study of Rivaroxaban for central venous catheter associated upper extremity deep vein thrombosis in cancer patients (Catheter 2). Thromb Res. 2017. pii: S0049-3848(17)30257-8. DOI: 10.1016/j.thromres.2017.04.003.




DOI: http://dx.doi.org/10.18233/APM42No5pp251%202591889

Enlaces refback

  • No hay ningún enlace refback.