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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Incidence of umbilical vein catheter-associated thrombosis of the portal system: A systematic review and meta-analysis
Iliana Bersani, Fiammetta Piersigilli, Giulia Iacona, Immacolata Savarese, Francesca Campi, Andrea Dotta, Cinzia Auriti, Enrico Di Stasio, Matteo Garcovich
Iliana Bersani, Immacolata Savarese, Francesca Campi, Andrea Dotta, Cinzia Auriti, Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome 00165, Italy
Fiammetta Piersigilli, Department of Neonatology, Cliniques Universitaires Saint Luc, Universitè Catholique de Louvain, Bruxelles 1200, Belgium
Giulia Iacona, Faculty of Medicine, Imperial College London, London SW7 2AZ, United Kingdom
Enrico Di Stasio, Department of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma 00168, Italy
Matteo Garcovich, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
Matteo Garcovich, CEMAD Digestive Disease Center, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Author contributions: Bersani I, Piersigilli F, Iacona G, Di Stasio E and Garcovich M contributed to conceptualization, systematic review, investigation, supervision, writing first draft, review and editing; Savarese I, Campi F, Dotta A and Auriti C contributed to conceptualization, investigation, review and editing; all authors revised the manuscript critically for intellectual content and have approved the final version.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Enrico Di Stasio, MD, PhD, Academic Research, Doctor, Department of Biochemistry and Clinical Biochemistry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo gemelli 8, Roma 00168, Italy. enrico.distasio@unicatt.it
Received: March 21, 2021
Peer-review started: March 21, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: October 14, 2021
Article in press: October 14, 2021
Published online: November 27, 2021
ARTICLE HIGHLIGHTS
Research background
The use of umbilical venous catheters (UVCs) in the perinatal period may be associated with severe complications, including the occurrence of portal vein thrombosis (PVT).
Research motivation
Although multiple observational studies have provided an overview about the risk of PVT after UVC positioning, no studies/reviews explored systematically this issue.
Research objectives
The main goal was to investigate the most accurate information about the actual incidence of UVC-related PVT in the neonatal setting, and to assess if any particular risk factor was systematically associated with the development of such complication.
Research methods
A systematic and comprehensive database searching (PubMed, Cochrane Library, Scopus, Web of Science) was performed for prospective cohort studies, retrospective cohort studies and case-control studies from 1980 to 2020. Incidence estimates were pooled by using random effects meta-analyses. The quality of included studies was assessed using the Newcastle-Ottawa scale.
Research results
Sixteen studies were considered eligible and included in the final analyses. The data confirmed the relevant risk of UVC-related thrombosis with a mean pooled incidence of 12%, although it varied across studies (0%-49%).
Research conclusions
This is the first systematic review specifically investigating the incidence of UVC-related PVT. The use of UVCs requires a high index of suspicion, because its use is significantly associated with PVT.
Research perspectives
Large prospective randomized studies and updated guidelines are warranted in order to define the best management of this dreaded complication.
