TY - CHAP M1 - Book, Section TI - Vasospasms and Thromboembolism A1 - Gomella, Tricia Lacy A1 - Eyal, Fabien G. A1 - Bany-Mohammed, Fayez PY - 2020 T2 - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e AB - An infant with an indwelling umbilical artery catheter develops a vasospasm in 1 leg. The nurse notifies you that another infant with an indwelling umbilical line has no pulses in the lower legs with severely decreased perfusion. Infants during the first month of life are at much higher risk of thrombosis and its complications when compared to any other pediatric age. This is due to many factors: an immature coagulation and fibrinolytic system (hypofibrinolytic state, decreased synthesis and altered function of some coagulation proteins, accelerated clearance of factors, platelet function differences, more active coagulation mechanism), smaller vessel size, and frequent indwelling catheter use (thrombogenic material in catheter, catheter slows blood flow and may damage the vascular endothelium, frequent medications may damage vessel wall). Other risks include maternal, delivery, neonatal, acquired, and inherited prothrombotic abnormalities. Incidences vary depending on the source, type of thrombosis, and screening methods used, but overall incidence of a symptomatic thromboembolic event is 5.1 per 100,000 live births and 2.4 to 6.8 per 1000 neonatal intensive care unit (NICU) admissions, affecting term and preterm male and females equally. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1168357125 ER -