부산대학교 도서관

The use of broviac catheters (B) for parenteral alimentation of very low birth weight infants is increasing. Thrombosis (T) and sepsis (S) are life-threatening complications of B use. 57B were inserted in the last year. Echocardiogram (Echo) and if necessary venograms were done for evidence of T. Blood cultures through the B and peripheral vein were done if there was clinical suspicion of S. Of the 57B inserted there were 8(14%) T episodes and 18(31%) S episodes. Mean catheter days (MCD) before T was noted were 47.5 days.Four patients developed right atrial T one of whom had repeated episodes of severe bradycardia which resolved as T improved. Another had significant superior vena cava (SVC) syndrome related to a large T. Two patients had T limited to the SVC and were diagnosed by venograms. Symptomatic T was treated with urokinase (1500-20,000U/kg/hour for 1 hr to 10 days, n=7), heparinized (n=3) and/or removal of B(n=1). In one infant on urokinase, T embolized causing pulmonary infarction. S was treated with appropriate antibiotics and/or removal of B. As shown B are associate with significant morbidity and should be used with caution. If B are used serial Echo are recommended to monitor for T episodes. Urokinase can be used to successfully treat T episodes.