This study included seven premature infants who were hospitalized in the neonatal intensive care unit (NICU) of Peking University Third Hospital from 1 January 2014-30 June 2021, and suffered PICC-related
venous thrombosis. The control group included premature infants (n = 56) matched (1:8) by the following: Did not experience
venous thrombosis; born with a similar gestational age (±2 w),
birth weight (±200 g); and received PICC catheterization in the same period (±4 w). Clinical neonatal data were collected through the hospital electronic medical record system and analyzed using SPSS version 23.
RESULTS: The incidence of PICC-related
thrombus was 0.23% (7/3043. Univariate analysis revealed that, compared to the non-thrombotic group, mothers in the
thrombosis group had
autoimmune diseases (χ2 = 9.844, p = 0.030) and used anticoagulative drugs during pregnancy (χ2 = 8.036, p = 0.025). The corrected gestational age when PICC-related
thrombosis occurred in the
thrombosis group was 32 + 6 (30 + 1, 34 + 1) weeks. The average time from
catheter placement to
thrombosis was 5 (1, 12) days. Among infants, 85.7% (6/7) experienced
deep vein thrombosis, of which four were in the lower extremity veins; three occurred within 2 days after
central venous catheter extubation, and four occurred during
central venous catheter indwelling. The clinical manifestations of
thrombosis include skin
edema, color changes, and skin temperature changes in the affected limbs. The seven neonates had normal coagulation at the time of
thrombus diagnosis, but D-dimers significantly increased 1-2 days after
thrombosis, returning to normal 5-8 days after
thrombus. The
thrombus persisted for 4.5 (3, 8) days. All seven neonates were treated with
low molecular weight heparin calcium anticoagulation for 10 (3, 17) days and recovered completely.
CONCLUSIONS: PICC-related
thrombosis occurred within 1 week after
catheter placement, and
thrombosis more likely happened in infants whose mothers had
autoimmune disease. When this high-risk factor exists and the patient has been intubated for 1 week and has sudden swelling in the intubated limb, venous ultrasound should be performed immediately to diagnose, and treatment should be provided in a timely manner to reduce adverse events.