Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study
Background: One of the complications associated with central venous catheter (CVC) placement is catheter related deep vein thrombosis (CR-DVT). However a literature search revealed little evidence of this recognised complication. The primary aim of this study was to establish the incidence rate and...
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| Format: | Article |
| Language: | English |
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Palacký University Olomouc, Faculty of Medicine and Dentistry
2017-12-01
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| Series: | Biomedical Papers |
| Subjects: | |
| Online Access: | https://biomed.papers.upol.cz/artkey/bio-201704-0006_Central_venous_catheter-related_thrombosis_in_intensive_care_patients_-_incidence_and_risk_factors_A_prospecti.php |
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| author | Ondrej Hrdy Eva Strazevska Petr Suk Robert Vach Radim Karlik Jiri Jarkovsky Igor Sas Roman Gal |
| author_facet | Ondrej Hrdy Eva Strazevska Petr Suk Robert Vach Radim Karlik Jiri Jarkovsky Igor Sas Roman Gal |
| author_sort | Ondrej Hrdy |
| collection | DOAJ |
| description | Background: One of the complications associated with central venous catheter (CVC) placement is catheter related deep vein thrombosis (CR-DVT). However a literature search revealed little evidence of this recognised complication. The primary aim of this study was to establish the incidence rate and risk factors for the development of CR-DVT in our critically ill adult patients.
Methods: All critically ill adult patients admitted to the medical-surgical ICU with CVC inserted were included in this observational prospective study. After catheter removal we performed duplex ultrasound examination to assess the patency of the vein and establish if CR-DVT was present.
Results: A total number of 308 catheters met the inclusion criteria of which 198 were included in the statistical analysis. The CVC was inserted into a subclavian vein (SCV) in 139 (70%) cases and in an internal jugular vein (IJV) in 59 (30%) cases. The 28-day mortality rate was 14.1%. We found CR-DVT during duplex ultrasound examination in 47 (26%) of all cases. 33 (70%) of the CR-DVT were diagnosed in the IJV and 14 (30%) in the SCV. The risk factors for the development of CR-DVT we identified included cannulation of the IJV and the use of treatment dose of LMWH. The effect of CR-DVT on 28-day mortality was not statistically significant.
Conclusion: The risk factors for CR-DVT we identified were IJV as a site for CVC cannulation and the use of therapeutic anticoagulation prior to cannulation. Our recommendation would be preferential cannulation of a subclavian vein as opposed to an internal jugular vein in order to reduce the risk of CR-DVT. |
| first_indexed | 2024-12-13T03:15:07Z |
| format | Article |
| id | doaj.art-a48f356e5ad84ae084a40fbe29af8ce0 |
| institution | Directory Open Access Journal |
| issn | 1213-8118 1804-7521 |
| language | English |
| last_indexed | 2024-12-13T03:15:07Z |
| publishDate | 2017-12-01 |
| publisher | Palacký University Olomouc, Faculty of Medicine and Dentistry |
| record_format | Article |
| series | Biomedical Papers |
| spelling | doaj.art-a48f356e5ad84ae084a40fbe29af8ce02022-12-22T00:01:30ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212017-12-01161436937310.5507/bp.2017.034bio-201704-0006Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational studyOndrej Hrdy0Eva Strazevska1Petr Suk2Robert Vach3Radim Karlik4Jiri Jarkovsky5Igor Sas6Roman Gal7Department of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicInstitute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech RepublicBackground: One of the complications associated with central venous catheter (CVC) placement is catheter related deep vein thrombosis (CR-DVT). However a literature search revealed little evidence of this recognised complication. The primary aim of this study was to establish the incidence rate and risk factors for the development of CR-DVT in our critically ill adult patients. Methods: All critically ill adult patients admitted to the medical-surgical ICU with CVC inserted were included in this observational prospective study. After catheter removal we performed duplex ultrasound examination to assess the patency of the vein and establish if CR-DVT was present. Results: A total number of 308 catheters met the inclusion criteria of which 198 were included in the statistical analysis. The CVC was inserted into a subclavian vein (SCV) in 139 (70%) cases and in an internal jugular vein (IJV) in 59 (30%) cases. The 28-day mortality rate was 14.1%. We found CR-DVT during duplex ultrasound examination in 47 (26%) of all cases. 33 (70%) of the CR-DVT were diagnosed in the IJV and 14 (30%) in the SCV. The risk factors for the development of CR-DVT we identified included cannulation of the IJV and the use of treatment dose of LMWH. The effect of CR-DVT on 28-day mortality was not statistically significant. Conclusion: The risk factors for CR-DVT we identified were IJV as a site for CVC cannulation and the use of therapeutic anticoagulation prior to cannulation. Our recommendation would be preferential cannulation of a subclavian vein as opposed to an internal jugular vein in order to reduce the risk of CR-DVT.https://biomed.papers.upol.cz/artkey/bio-201704-0006_Central_venous_catheter-related_thrombosis_in_intensive_care_patients_-_incidence_and_risk_factors_A_prospecti.phpcentral venous catheterdeep vein thrombosisrisk factorscritical care |
| spellingShingle | Ondrej Hrdy Eva Strazevska Petr Suk Robert Vach Radim Karlik Jiri Jarkovsky Igor Sas Roman Gal Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study Biomedical Papers central venous catheter deep vein thrombosis risk factors critical care |
| title | Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study |
| title_full | Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study |
| title_fullStr | Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study |
| title_full_unstemmed | Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study |
| title_short | Central venous catheter-related thrombosis in intensive care patients - incidence and risk factors: A prospective observational study |
| title_sort | central venous catheter related thrombosis in intensive care patients incidence and risk factors a prospective observational study |
| topic | central venous catheter deep vein thrombosis risk factors critical care |
| url | https://biomed.papers.upol.cz/artkey/bio-201704-0006_Central_venous_catheter-related_thrombosis_in_intensive_care_patients_-_incidence_and_risk_factors_A_prospecti.php |
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