172 - Neonatal Thrombosis Center: Five Year Analysis

Publication Number: 2166.172

Matthew A. Saxonhouse, Wake Forest School of Medicine, CHARLOTTE, NC, United States; Ashley Hinson, Levine Children's Hospital, Waxhaw, NC, United States; Jennifer Barnes, Levine Children's Hospital, Huntersville, NC, United States; Kathryn Six, Levine Children's Hospital, Charlotte, NC, United States; Brendan Kleiboer, Levine Children's Hospital, Charlotte, NC, United States

Background: Neonates are at high risk for symptomatic thromboses. Arterial and central venous catheters further increase this risk. Recommendations for treatment are mainly based on expert opinion and case series. Standardized care based on clinical protocols developed from specialized neonatal centers is vital to improve outcomes. A neonatal thrombosis center was created at Levine Children's Hospital in 2021 in order to improve care based on a standardized management/treatment protocol and to collect data.

Objective: To review data collected from our neonatal thrombosis center to highlight trends in outcomes based on following a standardized protocol.

Design/Methods: The neonatal thrombosis center was developed in 2021 in conjunction with Neonatology, Pediatric Hematology/Oncology, and Pediatric Pharmacists. A standardized protocol was designed and data was collected from all neonates with symptomatic thromboses admitted to the neonatal intensive care unit at Levine Children's Hospital. Anticoagulation and antithrombolytic treatments remained consistent following the standardized protocol. Treatment recommendations were made specifically by the investigators utilizing protocol and patient factors.

Results: There were 74 neonates evaluated for symptomatic thromboses. This represents an incidence of 1.3% per 5687 admissions. Mean gestational age was 35 weeks (22-41) and mean post-mentrual age was 38 weeks (27-67). Mean birth weight was 2464 grams. The sex breakdown was 57% to 43% of cases, male to female. The majority of venous thrombses were catheter related. There was only 1 antithrombolytic complication. Summary of data and treatments from the varying types of thromboses is presented in Table 1.

Conclusion(s): Implementing a standardized protocol for treatment of neonatal thromboses in conjunction with consistent clinician management resulted in very few complications. Outcomes were improved and complications were reduced. Data collected from our center will be used to provide guidelines for neonates affected by symptomatic thromboses nationwide.

Thromboses and Treatment Received
Listing of types of thromboses and treatment received at the neonatal thrombosis center at Levine Children's Hospital