PubMed Health⌕ Search

Biomedical subjects

G Wesström

Publications and source records attributed to G Wesström.

23 records · Page 2Linked to original sources

Umbilical artery catheterization in newborns. I. Thrombosis in relation to catheter type and position.

Seventy-one sick newborn infants, who had an umbilical artery catheterized, were randomized in one of four catheter groups: long end-hole-, short end-hole-, long side-hole- or short side-hole catheter. A long catheter means a high position of the catheter tip (Th6--11) and a short catheter a low position of the tip (L3--5). An angiography through the indwelling catheter in order to diagnose thrombosis was performed before the catheter was withdrawn. Dissection of the aorta and its brances was performed on infants who died. The total frequency of thromboses was 26%. There were no thromboses among infants with long end-hole catheters while infants with short end-hole catheters had thrombosis in 26%, long side-hole catheters in 33% and short side-hole catheters in 64%. Long end-hole catheters functioned better than the others. Only 6 of 16 infants with thrombosis had physical signs from the legs, while 12 infants without thrombosis had similar signs.

Catheterization↗

Umbilical artery catheterization in newborns. II. Infections in relation to catheterization.

Infections, as a complication of umbilical artery catheterization, were studied in 65 sick newborn infants. Every second day during the catheterization period peripheral blood cultures as well as blood samples for white cell count and platelets were taken. Cultures were taken from the catheter tips and from the umbilicus at the time of withdrawal of the catheter. Local or systemic antibiotics were not used prophylactically, but on rather broad clinical indications. No case of septicemia was found, but 8 infants had positive blood cultures and 16 had positive catheter tip cultures. Positive catheter tip culture occurred more often in infants who were born before 32 weeks of gestational age. Neither the duration of the catheterization nor the treatment with antibiotics influenced significantly the frequency of positive cultures.

Anti-Bacterial Agents↗

Umbilical artery catheterization in newborns. III. Thrombosis--a study of some predisposing factors.

Thrombosis following umbilical artery catheterization is a relatively frequent complication. Low fibrinolytic activity in the vessel walls, high factor VIII and low antithrombin III (AT III, Heparin cofactor activity) in blood are factors known to favour the formation of thrombosis. In 30 newborns who died and in 2 foetuses the fibrinolytic activity determined in the aorta and the femoral vessels was in the normal 'adult' range except for a few very immature infants and the foetuses. The five cases with arterial thrombosis were not associated with low fibrinolytic activity. The various factor VIII activities (VIII:C, VIIIR:Ag, and VIIIR:RCF) ant AT III were studied in 30 sick newborns and in 20 healthy newborns. The sick exhibited increased levels of various factor VIII activities (VIIIR:Ag and VIIIR:RCF mainly) and markedly reduced levels of AT III. The high factor VIII activities and the low AT III found will add to the existing risk of thrombosis due to the presence of a foreign material. AT III substitution is suggested as a possible prophylactic.

Antithrombin III↗

Aortic aneurysm developing after umbilical artery catheterization.

A variety of complications of umbilical vessel catheterization in the newborn have been reported by earlier investigators. This paper describes a case in which umbilical artery catheterization probably gave rise to an aortic aneurysm. The histological findings suggested that the hypoxic changes in the aortic wall as well as the mechanical effect of the catheter were involved in the origin of the aneurysm.

Aortic Aneurysm↗