Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

Eoghan E Laffan; Patrick J McNamara; Joao Amaral; Hilary Whyte; Johanne L'Herault; Michael Temple; Philip John; Bairbre L Connolly

doi:10.1007/s00247-009-1267-9

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Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

Journal article

Peer reviewed

Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

Eoghan E Laffan, Patrick J McNamara, Joao Amaral, Hilary Whyte, Johanne L'Herault, Michael Temple, Philip John and Bairbre L Connolly

Pediatric radiology, Vol.39(8), pp.781-790

08/2009

DOI: 10.1007/s00247-009-1267-9

PMID: 19430771

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Abstract

Interventional radiology (IR) procedures in very low birth-weight (VLBW) infants (<1.5 kg) are challenging due to size, immaturity, comorbidities and lack of devices of suitable size. Infants are moved from the neonatal intensive care unit to the IR suite, further exposing them to risk. Our purpose was to review our experience of interventional procedures in VLBW infants, specifically complications and potential risks. VLBW infants referred for image-guided therapy between 1998 and 2005 were identified and medical records reviewed. "Complications" were divided into: major or minor, periprocedural or postprocedural, and intervention-/device-related, patient-related or equipment-related. Transport risk index of physiological stability (TRIPS) scores were calculated. A total of 116 infants (68 male, 48 female) underwent 176 procedures (159 vascular access-related and 17 nonvascular). Of 158 complications identified, 116 were major and 42 were minor. Major complications included hypothermia (n=33), line manipulations/removals (n=25), bleeding (n=12), thrombosis (n=4), cardiac arrest (n=3), tamponade (n=2), and multiorgan failure (n=1). Of the complications, 119 were categorized as intervention-/device-related, 32 patient-related and 7 equipment-related. There were no significant differences between pre- and postprocedural TRIPS scores. Successful completion of IR procedures in the VLBW infant is possible, but complications still occur in these fragile infants.

Risk Assessment

Infant, Very Low Birth Weight

Surgery, Computer-Assisted - statistics & numerical data

Humans

Radiology, Interventional - statistics & numerical data

Risk Factors

Male

Survival Rate

Postoperative Complications - mortality

Incidence

Practice Patterns, Physicians' - statistics & numerical data

Canada - epidemiology

Survival Analysis

Female

Infant, Newborn

Details

Title: Subtitle: Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice
Creators: Eoghan E Laffan - Department of Diagnostic Imaging, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
Patrick J McNamara
Joao Amaral
Hilary Whyte
Johanne L'Herault
Michael Temple
Philip John
Bairbre L Connolly
Resource Type: Journal article
Publication Details: Pediatric radiology, Vol.39(8), pp.781-790
DOI: 10.1007/s00247-009-1267-9
PMID: 19430771
ISSN: 0301-0449
eISSN: 1432-1998
Language: English
Date published: 08/2009
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984093330302771

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