Efficacy of thromboresistant umbilical artery catheters in reducing aortic thrombosis and related complications |
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| Authors: | J C Jackson W E Truog J F Watchko L A Mack D R Cyr G van Belle |
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| Affiliation: | 1. Department of Pediatrics, University of Washington School of Medicine, Seattle USA;2. Department of Radiology, University of Washington School of Medicine, Seattle USA;3. Department of Biostatistics, University of Washington School of Medicine, Seattle USA;1. Radiation Safety Systems Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India;2. Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India;3. Radiation Technology Development Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India;4. Nuclear Agriculture and Biotechnology Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India;5. Radiochemistry Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India;1. Department of Physics, Electronics and Space Science, University School of Sciences, Gujarat University, Ahmedabad, 380 009, India;2. Solid State Physics Division, Bhabha Atomic Research Centre, Mumbai, 400 085, India;3. Department of Engineering of Materials and Ceramics/CICECO - Aveiro Institute of Materials, University of Aveiro, Aveiro, 3810-193, Portugal;4. Instituto Tecnologico de Aeronautica, Praça Mal. Eduardo Gomes, 50, São José dos Campos 12.228-900, Brazil;5. Instituto de Estudos Avançados, Trevo Cel. Av. Jose A. A. Amarante, São José dos Campos 12.228-001, Brazil;6. Technical Physics Division, Bhabha Atomic Research Centre, Mumbai, 400 085, India;7. Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400 094, India;8. National Institute for Space Research, Associated Laboratory for Sensors and Materials, Av. dos Astronautas, 1.758 - Jardim da Granja, São José dos Campos - SP, 12227-010, Brazil;9. Mechanical Metallurgy Division, Bhabha Atomic Research Centre, Mumbai, 400 085, India;1. Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA;2. Department of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA, USA;1. School of Materials Science & Engineering, Nanyang Technological University, Singapore, 639798, Singapore;2. Nanyang Institute of Technology in Health and Medicine, Nanyang Technological University, Singapore, 639798, Singapore;3. Department of Diagnostic Radiology, Singapore General Hospital, Singapore, 169608, Singapore;4. Institute of Materials Research and Engineering, A*STAR, Singapore, 138364, Singapore;5. School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, 639798, Singapore |
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| Abstract: | Previous in vitro and in vivo reports suggest that catheters constructed of polyurethane with heparin bonded to the surface (HB-PU) are less thrombogenic than catheters made of polyvinyl chloride (PVC). A randomized trial sufficiently large (power 80%) to detect a reduction in the incidence of umbilical artery (UA) catheter complications, including aortic thrombus formation, from 45% to 20% was conducted in 125 infants. The infants were monitored for complications possibly related to the use of a UA catheter, such as systemic hypertension and abnormalities of lower extremity perfusion. The presence of aortic thrombi was assessed by ultrasound study 3.5 +/- 1.2 (SD) days and 11.1 +/- 2.3 days after insertion of the catheter. The use of HB-PU umbilical catheters did not lead to a significant reduction in the incidence of complications and aortic thrombi compared with the use of PVC catheters. The lack of reduction may have been related to the prolonged duration of catheter use in both groups. A much larger study would have been required to detect a smaller, but perhaps clinically significant, reduction in catheter-associated complications. |
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