Arterial Thrombosis Secondary to Cardiac Catheterization in Neonates

Objective: Cardiac catheterization is one of the basic procedures applied in the diagnosis and treatment of cardiovascular diseases. Development of thrombosis is a serious complication of catheterization. In this study, the frequency and the factors affecting the development of arterial thrombosis were prospectively evaluated in neonates who were subjected to diagnostic or interventional cardiac catheterization. Methods: Twenty newborns that received femoral artery catheterization within 6-month period were enrolled in this study. Blood samples were taken for complete blood count, prothrombin, activated partial thromboplastin time, INR ratio and mutations of factorV Leiden, prothrombin 20210A, methylenetetrahydrofolate reductase C667T and A1298 before the procedure. 100 U/kg bolus of heparin was infused during catheterization. 28 U/kg/hour infusion of heparin was given to the patients with clinically suspected thrombosis during first few hours after catheterization. Doppler ultrasonography was performed in all patients within 6 hours after catheterization. Results: The gestational age of patients ranged from 31 to 40 weeks (median 39). Mean birth weight was 2996 ± 589 (1880-4000 gr). Arterial thrombosis was detected in 10 patients by Doppler USG. On development of arterial thrombosis, patient age, gender, diagnosis, treatments, platelet count, hemoglobin, prothrombin and activated partial thromboplastin time values, FactorV Leiden, prothrombin 20210A, methylenetetrahydrofolate reductase C667T and A1298 mutations were found as not impacting (p>0.05). Those who were found to have thrombosis in Doppler ultrasonography had lower INR levels compared to others (p= 0.023). Conclusions: The rate of femoral arterial thrombosis in newborns after catheterization detected by Doppler ultrasonography was 50% in this study. Our data suggest that early clinical assessment for the diagnosis of thrombosis may be misleading but Doppler ultrasonography may be helpful early detection. Further studies are needed to prediction appropriate drugs and/or doses for prevention of thrombosis after arterial catheterization in newborns

Evaluation of newborns with vitamin D deficiency: A single-center experience

Aim: To evaluate the demographic, clinical, and laboratory characteristics (primarily phosphorus, calcium (Ca), and alkaline phosphatase (ALP) levels of newborns with low 25-OHD levels. Methods: In this retrospective study, babies whose 25-OHD levels were determined during hospitalization were evaluated. The newborns were classified as stated by their serum 25-OHD levels as follows: severely deficient, <5 ng/mL (group 1); deficient, 5–20 ng/mL (group 2); and insufficient, 20 to 30 ng/mL (group 3). In addition to the newborns' serum 25-OHD levels, their serum Ca, phosphorus, parathormone (PTH), and alkaline phosphatase levels and their mothers' 25-OHD levels were also measured. Results: A total of 568 newborns were included. Serum 25-OHD level was severely deficient in 112 patients (19.7%). The mothers of the babies in group 1 were younger than those of the babies in the other groups. First PTH level (F3,1, p = 0.04) and maternal ALP level were highest in group 1. In all the groups, the maternal 25-OHD level was <30 ng/mL. Vitamin D supplementation rate during pregnancy was found to be significantly lower in the severely deficient and deficient groups than in the insufficient group (F1,84, p = 0.01). Conclusion: 25-OHD deficiency continues to be a problem among pregnant women and their babies in Turkey despite the introduction of a supplementation program. This study emphasizes the need to improve maternal 25-OHD status to support maternal and infant health. &nbsp

Rupture and displacement of umbilical arterial catheter: Bilateral arterial occlusion in a very low birth weight preterm

DILLI, DILEK/0000-0003-2634-2562WOS: 000360295600008PubMed: 26294163Umbilical vessel catheterization is a common procedure in Neonatal Intensive Care Units, especially in very low birthweight infants. Rarely, umbilical artery catheters break, and the retained fragments can cause thrombosis, infection, distal embolization, and even death. Herein, we describe a neonate with clinically significant bilateral limb ischemia developing after removal of a broken umbilical artery catheter. He was under vasodilator treatment in addition to fibrinolytic and anticoagulants. The evolution was favourable

Do toxic metals and trace elements have a role in the pathogenesis of conotruncal heart malformations?

Objective: The aim of the present study was to determine the role of toxic elements and trace elements in the pathogenesis of conotruncal heart defects by measuring their concentrations in the first meconium specimens of the affected newborns. Methods: Concentrations of lead, cadmium, iron, zinc, and copper were measured in 1st-day meconium specimens that were collected from 60 newborns with conotruncal heart defects (Group I) and 72 healthy newborns (Group II). Results: The newborns with conotruncal defects and the healthy newborns had statistically similar demographic and clinical characteristics. When compared with healthy newborns, mean concentrations of lead, cadmium, iron, zinc, and copper were significantly higher in newborns with conotruncal heart defects (p = 0.001 for each). In total, 51 newborns with conotruncal heart defects had normal karyotype. These newborns had significantly higher concentrations of lead, cadmium, iron, zinc, and copper when compared with healthy newborns. There were significant and positive correlations between the concentrations of lead and cadmium (r = 0.618, p= 0.001), lead and iron (r= 0.368, p= 0.001), lead and zinc (r = 0.245, p= 0.005), lead and copper (r = 0.291, p= 0.001), cadmium and iron (r = 0.485, p= 0.001), cadmium and zinc (r = 0.386, p= 0.001), and cadmium and copper (r = 0.329, p= 0.001). Conclusion: Toxic metals and trace elements may disturb DNA repair mechanisms by impairing DNA methylation profiles, and thus have a role in the pathogenesis of conotruncal heart defects

Additive effect of mesenchymal stem cells and defibrotide in an arterial rat thrombosis model

Background/aim. In this study, we aimed to investigate the additive effect of mesenchymal stem cells (MSC) and defibrotide (DFT) in a rat model of femoral arterial thrombosis. Methods. Thirty Sprague Dawley rats were included. An arterial thrombosis model by ferric chloride (FeCl3) was developed in the left femoral artery. The rats were equally assigned to 5 groups: Group 1-Sham-operated (without arterial injury); Group 2-Phosphate buffered saline (PBS) injected; Group 3-MSC; Group 4-DFT; Group 5-MSC + DFT. All had two intraperitoneal injections of 0.5 ml: the 1st injection was 4 h after the procedure and the 2nd one 48 h after the 1st injection. The rats were sacrificed 7 days after the 2nd injection. Results. Although the use of human bone marrow-derived (hBM) hBM-MSC or DFT alone enabled partial resolution of the thrombus, combining them resulted in near-complete resolution. Neovascularization was two-fold better in hBM-MSC + DFT treated rats (11.6 +/- 2.4 channels) compared with the hBM-MSC (3.8 +/- 2.7 channels) and DFT groups (5.5 +/- 1.8 channels) (P < 0.0001 and P= 0.002, respectively). Conclusion. The combined use of hBM-MSC and DFT in a rat model of arterial thrombosis showed additive effect resulting in near-complete resolution of the thrombus