Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit.

IF 2 4区医学 Q2 PEDIATRICS

Children-Basel Pub Date : 2024-11-17 DOI:10.3390/children11111394

Maha Azzam, Yousef M AlTalhi, Hani Alsawadi, Mohamed Humoodi, Abdullah Alzahrani, Amir Shehzad Hayat, Mohammed Bakhsh, Sara Osman

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引用次数: 0

Abstract

Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed.

Objective: To identify the incidence and risk factors for Central Venous Catheter-Related Thrombosis (CVC-RT) among patients admitted to the Pediatric Intensive Unit.

Method: This was a prospective, observational, single-center study that was conducted over 17 months from September 2019 to January 2021 at King Abdulaziz Medical City, Jeddah.

Design: Prospective observational study.

Setting: King Abdulaziz Medical City, a tertiary care center in the western region of Saudi Arabia.

Patients: Pediatric patients aged 1 to 168 months who were admitted to the PICU and required central line insertion (whether inserted centrally or peripherally) for more than 48 hours were included. Screening for thrombosis was performed within day 4-7 post-line insertion and again on the 14th day.

Results: A total of 255 patients were enrolled over 17 months. The incidence rate of CVC-RT was 5.4%. The type of CVC was significantly different between the two groups; in the no thrombosis group, 59.2% had a central line while in the CVC-RT groups, 51.9% had a PIC line (p = 0.027). In a multivariate regression analysis including patients' clinical profile, high D-dimer as baseline and low platelets were both significant risk factors for CVC-RT [adjusted OR = 3.22, CI (1.25-8.28), p = 0.015 and adjusted OR = 7.38, CI (2.18-25.02), p = 0.001], respectively.

Conclusions: The current study found that PIC line was associated with an increased risk of CVC-RT, which is congruent with the literature. As children with CVC can have multiple risk factors for developing CVC-RT, it is important to conduct further large prospective studies to identify such factors and decrease the incidence of CVC-RT.

查看原文本刊更多论文

中心静脉导管血栓形成的发生率和风险因素：单中心儿科重症监护室的研究结果。

背景：中心静脉导管（CVC）是管理急性病患儿和需要复杂护理的患儿所必需的重要工具。通过 CVC 可以输注静脉药物、液体、血液制品、化疗、全营养，并在需要时无痛抽取血液进行化验：确定儿科重症监护室住院病人中中心静脉导管相关血栓形成（CVC-RT）的发生率和风险因素：这是一项前瞻性、观察性、单中心研究，于2019年9月至2021年1月在吉达阿卜杜勒阿齐兹国王医疗城进行，历时17个月：前瞻性观察研究：阿卜杜勒阿齐兹国王医疗城是沙特阿拉伯西部地区的一家三级医疗中心：研究对象：年龄在1至168个月之间、入住重症监护病房（PICU）且需要插入中心静脉管（无论是中心插入还是外周插入）超过48小时的儿科患者。插管后第 4-7 天进行血栓筛查，第 14 天再次进行筛查：结果：在17个月的时间里，共纳入了255名患者。CVC-RT的发生率为5.4%。两组患者的 CVC 类型存在显著差异；无血栓形成组中，59.2% 的患者使用中心静脉置管，而 CVC-RT 组中，51.9% 的患者使用 PIC 管路（p = 0.027）。在包括患者临床特征的多变量回归分析中，基线D-二聚体高和血小板低分别是CVC-RT的显著风险因素[调整后OR = 3.22，CI (1.25-8.28)，p = 0.015和调整后OR = 7.38，CI (2.18-25.02)，p = 0.001]：本研究发现，PIC 管路与 CVC-RT 风险增加有关，这与文献报道一致。由于CVC患儿可能有多种发生CVC-RT的危险因素，因此进一步开展大型前瞻性研究以确定这些因素并降低CVC-RT的发生率非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Children-Basel PEDIATRICS-

CiteScore

2.70

自引率

16.70%

发文量

1735

审稿时长

6 weeks

期刊介绍： Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.