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Characterizing the Risk Factors Associated With Venous Thromboembolism in Pediatric Patients After Central Venous
Sarah Wisecup1, Shannan Eades2, Yuliya Turiy3
1Children's Hospital of San Antonio-Christus Santa Rosa, San Antonio, Texas.
Insights
Pediatric patients with central venous lines face increased risk of venous thromboembolism, especially those with congenital heart defects or receiving parenteral nutrition. Reducing central line use may prevent clots.
Area of Science:
- Pediatric Thrombosis
- Vascular Access Devices
- Clinical Risk Factors
Background:
- Venous thromboembolism (VTE) is a growing concern in children.
- Identifying at-risk pediatric populations is crucial for effective preventative strategies.
- Central venous lines are frequently used in pediatric care, necessitating an understanding of associated risks.
Purpose of the Study:
- To identify risk factors for VTE in pediatric patients with central venous lines.
- To inform preventative measures and therapeutic strategies for pediatric thrombosis.
Main Methods:
- Observational, retrospective, case-control study design.
- Inclusion of 150 pediatric patients (0-18 years).
- Comparison between patients with central lines and those with confirmed VTE and central lines.
Main Results:
- Multiple comorbidities, especially congenital heart defects, significantly increase VTE risk (34.7% vs. 14.7%, p < 0.005).
- Parenteral nutrition via central line is associated with higher thrombosis rates (34.7% vs. 18.7%, p = 0.03).
- Central line location also impacts clot formation risk.
Conclusions:
- Increased awareness of central line-associated VTE is needed.
- Strategies to minimize central line placement number and duration should be implemented.
- Further research on thromboprophylaxis in high-risk pediatric patients is warranted.
Objectives:
With the apparent increase in venous thromboembolism noted in the pediatric population, it is important to define which children are at risk for clots and to determine optimal preventative therapy. The purpose of this study was to determine the risk factors for venous thromboembolism in pediatric patients with central venous line placement.
Methods:
This was an observational, retrospective, case-control study. Control subjects were patients aged 0 to 18 years who had a central venous line placed. Case subjects had a central line and a radiographically confirmed diagnosis of venous thromboembolism.
Results:
A total of 150 patients were included in the study. Presence of multiple comorbidities, particularly the presence of a congenital heart defect (34.7% case vs. 14.7% control; p < 0.005), was found to put pediatric patients at increased risk for thrombosis. Additionally, the administration of parenteral nutrition through the central line (34.7% case vs. 18.7% control; p = 0.03) and location of the line increased the risk for clot formation.
Conclusions:
With increased awareness of central venous line-related thromboembolism, measures should be taken to reduce the number and duration of central line placements, and further studies addressing the need for thromboprophylaxis should be conducted.
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