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

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...

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Main Authors: Maha Azzam, Yousef M. AlTalhi, Hani Alsawadi, Mohamed Humoodi, Abdullah Alzahrani, Amir Shehzad Hayat, Mohammed Bakhsh, Sara Osman
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/11/11/1394
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author Maha Azzam
Yousef M. AlTalhi
Hani Alsawadi
Mohamed Humoodi
Abdullah Alzahrani
Amir Shehzad Hayat
Mohammed Bakhsh
Sara Osman
author_facet Maha Azzam
Yousef M. AlTalhi
Hani Alsawadi
Mohamed Humoodi
Abdullah Alzahrani
Amir Shehzad Hayat
Mohammed Bakhsh
Sara Osman
author_sort Maha Azzam
collection DOAJ
description 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 (<i>p</i> = 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), <i>p</i> = 0.015 and adjusted OR = 7.38, CI (2.18–25.02), <i>p</i> = 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.
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spelling doaj-art-675025a5ddce48d6a200f3fa087e6da82024-11-26T17:57:43ZengMDPI AGChildren2227-90672024-11-011111139410.3390/children11111394Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care UnitMaha Azzam0Yousef M. AlTalhi1Hani Alsawadi2Mohamed Humoodi3Abdullah Alzahrani4Amir Shehzad Hayat5Mohammed Bakhsh6Sara Osman7Department of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaPediatric Intensive Care Unit, Royal Hospital for Children, Glasgow G51 4TF, UKDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz Medical City, P.O. Box 65362, Jeddah 21556, Saudi ArabiaBackground: 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 (<i>p</i> = 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), <i>p</i> = 0.015 and adjusted OR = 7.38, CI (2.18–25.02), <i>p</i> = 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.https://www.mdpi.com/2227-9067/11/11/1394central venous thrombosisdeep vein thrombosisPICC lines thrombosis
spellingShingle Maha Azzam
Yousef M. AlTalhi
Hani Alsawadi
Mohamed Humoodi
Abdullah Alzahrani
Amir Shehzad Hayat
Mohammed Bakhsh
Sara Osman
Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
Children
central venous thrombosis
deep vein thrombosis
PICC lines thrombosis
title Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
title_full Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
title_fullStr Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
title_full_unstemmed Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
title_short Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
title_sort incidence of and risk factors for central venous catheter thrombosis results from a single center pediatric intensive care unit
topic central venous thrombosis
deep vein thrombosis
PICC lines thrombosis
url https://www.mdpi.com/2227-9067/11/11/1394
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