Neonatal XXXX : report of a prospective Canadian and international registry.

@entity1 @entity64 @entity49 @entity1150 @entity281 @entity715
OBJECTIVE: We sought to obtain representative data on the risk factors, diagnosis, current management, and short-term outcome of neonatal @entity715 . RESEARCH DESIGN: A case registry was established at McMaster University. Standardized questionnaires were mailed to collaborators at participating centers every 4 to 6 months. SETTING: Eighty-five level III and modified level II neonatal units in North America, Europe, and Australia were invited to join the registry. @entity1 : Eligible @entity1 were born between January 1990 and June 1993. Large-vessel @entity715 was diagnosed during the first month of life or up to 44 weeks post-conception after premature birth. The clinical impression of @entity715 was confirmed using at least one imaging technique. RESULTS: Physicians in 64 centers expressed their willingness to participate. A total of 97 cases (excluding @entity64 ) were registered from 29 centers. Spontaneous @entity49 (n = 21) was diagnosed at a median age of 2 days. The other venous (n = 39), arterial (n = 33), and mixed (n = 4) @entity715 presented later; 89% of them were associated with an intravascular catheter and 29% with @entity281 . Doppler ultrasonography was the definitive diagnostic test in 68% of cases; contrast angiography was performed infrequently (14%). A third of all @entity1 (but 62% of @entity1 with @entity49 ) received supportive therapy only. Thrombolytic agents were prescribed for 28% of catheter-associated @entity1150 and 30% of all arterial @entity715 . The remainder of the @entity1 were given heparin. Most @entity1 (82%) survived to hospital discharge. Mortality rates were highest among @entity1 with aortic @entity715 or central venous line-associated @entity715 affecting the right atrium or the superior vena cava (33%). CONCLUSIONS: Neonatal @entity715 is diagnosed fairly rarely. With the exception of spontaneous @entity49 , almost all cases are associated with indwelling catheters. Doppler ultrasound techniques are the most popular means of confirming the diagnosis in virtually all centers. Treatment varies greatly among different centers, probably because of the lack of scientific evidence about the optimum management of affected @entity1 .
