RT Book, Section A1 Gomella, Tricia Lacy A1 Eyal, Fabien G. A1 Bany-Mohammed, Fayez SR Print(0) ID 1168357125 T1 Vasospasms and Thromboembolism T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781259644818 LK accesspediatrics.mhmedical.com/content.aspx?aid=1168357125 RD 2024/03/28 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.