Incidence and risk factors of catheter-related deep vein thrombosis in a pediatric intensive care unit: A prospective study

被引:116
作者
Beck, C
Dubois, J
Grignon, AE
Lacroix, J
Dnuiz, I
David, M
机构
[1] Univ Montreal, Hop St Justine, Div Hematol Oncol, Dept Pediat, Montreal, PQ H3T 1C5, Canada
[2] Univ Montreal, Hop St Justine, Dept Radiol, Montreal, PQ H3T 1C5, Canada
关键词
D O I
10.1016/S0022-3476(98)70226-4
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To estimate the incidence and to characterize risk factors for central venous catheter (CVC)-related deep vein thrombosis (DVT) in a pediatric intensive care unit. Study design: Consecutive children admitted to a pediatric intensive care unit who required a CVC for more than 48 hours were examined by Doppler ultrasonography of the catheterized vein at days 2, 4, 6, or 7 after insertion and weekly thereafter until CVC removal. Results: The incidence of CVC-related DVT was 18.3% (17 of 93) (95% confidence interval = 10.2% to 25.8%). Thromboses were diagnosed within the first 4 days of catheter placement for 15 of 17 CVC-related thromboses. Multivariate analysis showed that risk factors most predictive of CVC-related DVT were presence of a cancer (odds ratio = 17.23, 95% confidence interval = 1.5 to 194) and young age (odds ratio for age = 0.72, 95% confidence interval = 0.54 to 0.96). Conclusion: The frequency of CVC-related DVT is substantial in pediatric intensive care units. Risk is highest during the 4 days after insertion and decreases thereafter. The clinical impact, optimal prevention, and therapy of these thromboses remain to be determined.
引用
收藏
页码:237 / 241
页数:5
相关论文
共 26 条
[1]   VENOUS THROMBOEMBOLIC COMPLICATIONS (VTE) IN CHILDREN - FIRST ANALYSES OF THE CANADIAN REGISTRY OF VTE [J].
ANDREW, M ;
DAVID, M ;
ADAMS, M ;
ALI, K ;
ANDERSON, R ;
BARNARD, D ;
BERNSTEIN, M ;
BRISSON, L ;
CAIRNEY, B ;
DESAI, D ;
GRANT, R ;
ISRAELS, S ;
JARDINE, L ;
LUKE, B ;
MASSICOTTE, P ;
SILVA, M .
BLOOD, 1994, 83 (05) :1251-1257
[2]   A CROSS-SECTIONAL STUDY OF CATHETER-RELATED THROMBOSIS IN CHILDREN RECEIVING TOTAL PARENTERAL-NUTRITION AT HOME [J].
ANDREW, M ;
MARZINOTTO, V ;
PENCHARZ, P ;
ZLOTKIN, S ;
BURROWS, P ;
INGRAM, J ;
ADAMS, M ;
FILLER, R .
JOURNAL OF PEDIATRICS, 1995, 126 (03) :358-363
[3]   MURAL THROMBI IN CHILDREN - POTENTIALLY LETHAL COMPLICATION OF CENTRAL VENOUS HYPERALIMENTATION [J].
BAGWELL, CE ;
MARCHILDON, MB .
CRITICAL CARE MEDICINE, 1989, 17 (03) :295-296
[4]   GREAT VEIN AND RIGHT ATRIAL THROMBOSIS IN CRITICALLY ILL INFANTS AND CHILDREN WITH CENTRAL VENOUS LINES [J].
BERMAN, W ;
FRIPP, RR ;
YABEK, SM ;
WERNLY, J ;
CORLEW, S .
CHEST, 1991, 99 (04) :963-967
[5]   EVALUATION OF DOPPLER EXAMINATION FOR DIAGNOSIS OF CATHETER-RELATED DEEP-VEIN THROMBOSIS [J].
BONNET, F ;
LORIFERNE, JF ;
TEXIER, JP ;
TEXIER, M ;
SALVAT, A ;
VASILE, N .
INTENSIVE CARE MEDICINE, 1989, 15 (04) :238-240
[6]   SUBCLAVIAN VEIN CATHETERIZATION IN CRITICALLY ILL CHILDREN - ANALYSIS OF 322 CANNULATIONS [J].
CASADOFLORES, J ;
VALDIVIELSOSERNA, A ;
PEREZJURADO, L ;
POZOROMAN, J ;
MONLEONLUQUE, M ;
GARCIAPEREZ, J ;
RUIZBELTRAN, A ;
GARCIATERESA, MA .
INTENSIVE CARE MEDICINE, 1991, 17 (06) :350-354
[7]   AN ULTRASTRUCTURAL-STUDY OF THE INTIMAL INJURY INDUCED BY AN INDWELLING UMBILICAL ARTERY CATHETER [J].
CHIDI, CC ;
KING, DR ;
BOLES, ET .
JOURNAL OF PEDIATRIC SURGERY, 1983, 18 (02) :109-115
[8]   VENOUS THROMBOEMBOLIC COMPLICATIONS IN CHILDREN [J].
DAVID, M ;
ANDREW, M .
JOURNAL OF PEDIATRICS, 1993, 123 (03) :337-346
[9]   Venous catheter thrombus formation and pulmonary embolism in children [J].
Derish, MT ;
Smith, DW ;
Frankel, LR .
PEDIATRIC PULMONOLOGY, 1995, 20 (06) :349-354
[10]   THROMBOSIS AND EMBOLISM IN LONG-TERM CENTRAL VENOUS ACCESS FOR PARENTERAL-NUTRITION [J].
DOLLERY, CM ;
SULLIVAN, ID ;
BAURAIND, O ;
BULL, C ;
MILLA, PJ .
LANCET, 1994, 344 (8929) :1043-1045