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Observation of short-term catheter induced thrombosis in children treated with blood purification
1Department of Pediatrics, West China Second University Hospital of Sichuan University, Chengdu, China.
Insights
Children undergoing blood purification with femoral venous catheters face a high risk of deep venous thrombosis (DVT). Fortunately, this condition is typically asymptomatic and resolves well with treatment, showing a good prognosis.
Area of Science:
- Pediatric Nephrology
- Vascular Medicine
- Critical Care Medicine
Background:
- Limited research exists on catheter-induced thrombosis in pediatric blood purification.
- Assessing the safety and incidence of thrombosis is crucial for this patient population.
Purpose of the Study:
- To determine the incidence and evolution of thrombosis in children undergoing blood purification.
- To identify risk factors associated with catheter-induced thrombosis.
Main Methods:
- 119 children treated with blood purification were enrolled.
- Data on baseline characteristics, coagulation, and catheter type were collected.
- Follow-up included ultrasound of femoral veins for 2 months to assess thrombosis.
Main Results:
- Deep venous thrombosis (DVT) occurred in 79.8% of patients, often asymptomatic.
- Thrombosis incidence showed no significant difference based on age, sex, or catheter size (8F vs. 11F).
- Thrombolysis was highly successful with oral dipyridamole treatment within two months.
Conclusions:
- Short-term femoral venous catheters in pediatric blood purification are associated with a high DVT risk.
- The majority of DVTs are asymptomatic with a favorable prognosis.
- Prompt treatment leads to successful thrombolysis.
Background:
No studies have assessed the safety of short-term catheter-induced thrombosis in children treated with blood purification. The aim of this study was to determine the incidence and evolution of thrombosis in the children.
Methods:
One hundred nineteen (119) children treated with blood purification were enrolled. The data of baseline characteristics, coagulation status and type of catheters were recorded. Thrombosis- related symptoms and signs, ultrasound examinations of the right femoral veins were followed for 2 months. The relationship between associated risk factors (age, sex and type of catheters) and thrombosis was analyzed.
Results:
Of the 119 patients, 95 (79.8%) developed deep venous thrombosis (DVT) in the right external iliac veins. In only one patient it was clinically obvious. The incidence of thrombosis had no significant difference between the following subgroups: 1. Children under 6 years (14/15, 93.3%), 6-12 years (63/78, 80.7%) and above 12 years (18/26, 69.2%) (p=0.436); 2. Male (57/66, 86.3%) and female patients (38/53, 71.6%) (p=0.448); 3. Children catheterized with 8F (52/63, 82.5%) and 11F catheters (43/56, 76.7%) (p=0.435). Thrombolysis was achieved in 77 cases (77/80, 96.3%) with treatment of oral dipyridamole at one month and 80 cases (100%) at two months.
Conclusion:
Children treated with blood purification through short-term femoral venous catheters have an increased risk of developing DVT, which is usually asymptomatic and good in prognosis. Hippokratia 2014; 18 (3): 245-250.
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