Diagnosis and management of catheter-related infected intracardiac thrombosis in premature infants

American Journal of Perinatology
J De SchepperL Sacre

Abstract

Infected right atrial thrombosis is an uncommon but severe complication of the use of central indwelling catheters in children. Massive thrombi around a right atrial catheter were seen in two critically ill premature infants after 3 weeks of parenteral nutrition. A catheter-related sepsis had previously occurred and had been treated by antibiotics. Subsequently, protracted thrombocytopenia, fluctuating hepatomegaly, and increasing respiratory distress were found in both cases. A right atrial mass was detected by 2 dimensional echocardiography. Cardiotomies for removal of the infected thrombus were performed with success in both cases. In one infant, weighing only 900 gm, surgical removal was accomplished with the aid of inflow stasis. Premature infants with catheter-related sepsis appear at greater risk for intracardiac thrombosis and should undergo echocardiography as part of their evaluation. Infected atrial thrombi can be safely removed by cardiotomy even in the very small premature infant.

Citations

Sep 5, 2007·Pediatric Cardiology·Edgard A BendalyRoger A Hurwitz
Sep 15, 2000·Clinics in Perinatology·M C SolaL M Rimsza
Jun 17, 2014·Pediatric Hematology and Oncology·Ibrahim İlker CetinGanime Ayar
Mar 20, 1998·AACN Clinical Issues·L A Wynsma
Mar 23, 2010·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Janet Yk YangAnthony Kc Chan
Jan 5, 2002·Paediatric Drugs·P C RimensbergerM Beghetti

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