PMID- 36696213
OWN - NLM
STAT- MEDLINE
DCOM- 20230331
LR  - 20230525
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 21
IP  - 4
DP  - 2023 Apr
TI  - NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): 
      evaluation of a national guideline on management of neonatal catheter-related 
      venous thrombosis.
PG  - 963-974
LID - S1538-7836(22)12806-0 [pii]
LID - 10.1016/j.jtha.2022.11.044 [doi]
AB  - 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.
CI  - Copyright (c) 2022 International Society on Thrombosis and Haemostasis. Published 
      by Elsevier Inc. All rights reserved.
FAU - van Ommen, C Heleen
AU  - van Ommen CH
AD  - Department of Pediatric Hematology, Erasmus University Medical Centre, Sophia 
      Children's Hospital, Rotterdam, The Netherlands. Electronic address: 
      c.vanommen@erasmusmc.nl.
FAU - Bergman, Klasien A
AU  - Bergman KA
AD  - Department of Neonatology, University Medical Centre Groningen, Beatrix 
      Children's Hospital, Groningen, The Netherlands.
FAU - Boerma, Marit
AU  - Boerma M
AD  - Erasmus University Medical Centre, Rotterdam, The Netherlands.
FAU - Bouma, Heleen A
AU  - Bouma HA
AD  - Department of Neonatology, University Medical Centre Groningen, Beatrix 
      Children's Hospital, Groningen, The Netherlands.
FAU - Donker, Albertine E
AU  - Donker AE
AD  - Department of Pediatrics, Maxima Medical Centre, Veldhoven, The Netherlands.
FAU - Gouvernante, Melissa
AU  - Gouvernante M
AD  - Faculty of Medicine, Erasmus University Medical Centre, Rotterdam, The 
      Netherlands.
FAU - Hulzebos, Christian V
AU  - Hulzebos CV
AD  - Department of Neonatology, University Medical Centre Groningen, Beatrix 
      Children's Hospital, Groningen, The Netherlands.
FAU - Khandour, Dalila
AU  - Khandour D
AD  - Faculty of Medicine, Erasmus University Medical Centre, Rotterdam, The 
      Netherlands.
FAU - Knol, Ronny
AU  - Knol R
AD  - Department of Neonatology, Erasmus University Medical Centre, Sophia Children's 
      Hospital, Rotterdam, The Netherlands.
FAU - Raets, Marlou A
AU  - Raets MA
AD  - Department of Neonatology, Maastricht University Medical Center, Maastricht, The 
      Netherlands.
FAU - Liem, K Djien
AU  - Liem KD
AD  - Department of Neonatology, Radboud University Medical Centre, Nijmegen, The 
      Netherlands.
FAU - van Lingen, Richard A
AU  - van Lingen RA
AD  - Department of Neonatology, Isala Hospital, Zwolle, The Netherlands.
FAU - van de Loo, Moniek
AU  - van de Loo M
AD  - Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical 
      Center, Amsterdam, The Netherlands.
FAU - Lopriore, Enrico
AU  - Lopriore E
AD  - Department of Pediatrics, Division of Neonatology, Willem-Alexander Children's 
      Hospital, Leiden University Medical Center, Leiden, The Netherlands.
FAU - van der Putten, Mayke
AU  - van der Putten M
AD  - Department of Neonatology, Maastricht University Medical Center, Maastricht, The 
      Netherlands.
FAU - Sol, Jeanine J
AU  - Sol JJ
AD  - Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, The Netherlands.
FAU - Suijker, Monique H
AU  - Suijker MH
AD  - Department of Pediatric Hematology, Wilhelmina Children's Hospital, University 
      Medical Centre Utrecht, Utrecht, The Netherlands.
FAU - Vijlbrief, Daniel C
AU  - Vijlbrief DC
AD  - Department of Neonatology, Wilhelmina Children's Hospital, University Medical 
      Centre Utrecht, Utrecht, The Netherlands.
FAU - Visser, Remco
AU  - Visser R
AD  - Department of Pediatrics, Division of Neonatology, Willem-Alexander Children's 
      Hospital, Leiden University Medical Center, Leiden, The Netherlands.
FAU - van Weissenbruch, Mirjam M
AU  - van Weissenbruch MM
AD  - Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical 
      Center, VU Medical Center, VU University, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20221222
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Anticoagulants)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
CIN - J Thromb Haemost. 2023 Apr;21(4):771-772. PMID: 36990518
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Humans
MH  - Female
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Anticoagulants/adverse effects
MH  - Tissue Plasminogen Activator
MH  - Prospective Studies
MH  - *Venous Thrombosis/diagnosis/drug therapy/epidemiology
MH  - Hemorrhage/chemically induced
MH  - *Upper Extremity Deep Vein Thrombosis
MH  - Catheters
OTO - NOTNLM
OT  - anticoagulation
OT  - catheter
OT  - neonate
OT  - thrombolysis
OT  - venous thromboembolism
COIS- Declaration of competing interests C.H.v.O. reports consulting fees paid to the 
      department from Bayer BV, Boehringer Ingelheim, and Daiichi Sankyo; lecture 
      honoraria paid to the department from Boehringer Ingelheim; and an unrestricted 
      grant paid to the department from Octapharma, all outside the submitted work.
EDAT- 2023/01/26 06:00
MHDA- 2023/03/31 06:42
CRDT- 2023/01/25 12:02
PHST- 2022/08/05 00:00 [received]
PHST- 2022/10/24 00:00 [revised]
PHST- 2022/11/15 00:00 [accepted]
PHST- 2023/03/31 06:42 [medline]
PHST- 2023/01/26 06:00 [pubmed]
PHST- 2023/01/25 12:02 [entrez]
AID - S1538-7836(22)12806-0 [pii]
AID - 10.1016/j.jtha.2022.11.044 [doi]
PST - ppublish
SO  - J Thromb Haemost. 2023 Apr;21(4):963-974. doi: 10.1016/j.jtha.2022.11.044. Epub 
      2022 Dec 22.