TOP 69 - Umbilical Arterial Catheter-Associated Thrombosis in a Congenital Diaphragmatic Hernia Population

Publication Number: 1828.TOP 69

Emily Schumann, Boston Children's Hospital, Boston, MA, United States; Hannah Fraser, Boston Children's Hospital, Boston, MA, United States; Farokh Demehri, Boston Children's Hospital, Brookline, MA, United States; Belinda Dickie, Boston Children's Hospital, Boston, MA, United States; Jill Zalieckas, Boston Children's Hospital, Boston, MA, United States

Background: Congenital diaphragmatic hernia (CDH) is a rare anomaly, occurring in approximately 2.3 per 10,000 live births, characterized by migration of abdominal contents into the thoracic cavity. This displacement causes underdevelopment of the lung parenchyma, pulmonary hypoplasia, and atypical pulmonary vasculature. Affected neonates are often admitted to an intensive care unit (ICU) after birth. An umbilical arterial catheter (UAC), a line used for blood pressure monitoring and arterial blood sampling, may be placed in these critically ill neonates.

Infants with indwelling UACs are known to be at risk for aortic thrombosis. Doppler ultrasonography has been the most common imaging modality used in diagnosing UAC-associated thrombosis. The pooled incidence of UAC-associated thrombosis in neonates across multiple studies is reported as 20%. Boo et al reported a significant difference in mean duration of UAC in-situ between infants who developed an aortic thrombus and infants who did not. It remains unclear if there is a significant difference in gestational age or other risk factors between these two groups. Furthermore, it is unknown whether the incidence of UAC-associated thrombosis in a CDH population differs from a general neonatal ICU population.

Objective: To determine the incidence of and risk factors associated with umbilical arterial catheter-associated aortic thrombosis in a congenital diaphragmatic hernia population

Design/Methods: This is a retrospective cohort study including all infants born between 2020 and 2025 with congenital diaphragmatic hernia that had an umbilical arterial catheter at a single tertiary referral hospital. Data has been collected on 44 patients that meet these inclusion criteria. The main study outcome is development of UAC-associated thrombosis. Additional variables collected include gestational age, birth weight, ECMO, laterality of CDH, liver position, duration of UAC, and location of UAC. Cohort characteristics are displayed in Table 1. To analyze the collected data, logistic regression will be used to identify the risk factors associated with the primary outcome. We anticipate data analysis to be complete within one month and manuscript and presentation creation in the following three months.

Table 1: Cohort Characteristics
Abbreviations: kg, kilograms; ECMO, extracorporeal membrane oxygenation; UAC, umbilical arterial catheter